Scientific article

High neutrophil to lymphocytes ratio is associated with sarcopenia risk in hospitalized cancer patients

Published inClinical nutrition, vol. 40, no. 1, p. 202-206
Publication date2021-01

Background & aims: Systemic inflammation has been reported as a new predictor for cancer outcomes. This study aimed i) to identify the neutrophil to lymphocytes ratio (NLR) cut-off point that best predicts sarcopenia and ii) to verify the association between NLR and sarcopenia risk in hospitalized cancer patients.

Methods: A cross-sectional study enrolled a total of 123 hospitalized cancer patients receiving chemotherapy and/or undergoing surgery. Systemic inflammation was assessed as revealed by circulating levels of C-reactive protein, neutrophils, platelet, and by calculating platelet-lymphocytes ratio (PLR) and NLR. Sarcopenia risk was assessed using the Strength, Assistance for walking, Rise from a chair, Climb stairs, and Falls (SARC-F; score≥4 identifies sarcopenia risk). ROC curve were used to identify the best NLR cut-off value which predicts sarcopenia risk. Differences between groups were tested using the T Student, Mann-Whitney, or Chi-Square tests. Logistic regression analyses were done to assess the association between NLR and sarcopenia risk.

Results: ROC curve revealed that the best cut-off point to predict sarcopenia risk was NLR ≥6.5 (sensitivity of 45% and specificity of 81%). Those with NLR ≥6.5 presented higher C-reactive protein, neutrophils, platelet-lymphocytes ratio (PLR), and SARC-F than NLR <6.5 group. A negative correlation was found between NLR and gait speed (r = -0.48, p = 0.0001), handgrip strength (r = -0.29, p = 0.002), arm circumference (r = -0.29, p = 0.002) and calf circumference (r = -0.28, p = 0.003). Those with increased NLR values were associated with high sarcopenia risk in crude model, as well as if adjusted by smoking, alcohol intake, and sex (OR:1.19 [95%CI:1.03-1.37], p = 0.013) or by BMI (OR:1.20 [95%CI:1.05-1.38], p = 0.006).

Conclusion: In hospitalized cancer patients, systemic inflammation measured by NLR was associated with increased sarcopenia risk.

  • Cancer
  • Inflammation
  • Lymphocytes
  • Muscle mass
  • Neutrophils
  • Sarcopenia
Citation (ISO format)
BORGES, Thaís C. et al. High neutrophil to lymphocytes ratio is associated with sarcopenia risk in hospitalized cancer patients. In: Clinical nutrition, 2021, vol. 40, n° 1, p. 202–206. doi: 10.1016/j.clnu.2020.05.005
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Article (Published version)
ISSN of the journal0261-5614

Technical informations

Creation01/10/2022 11:00:00 AM
First validation01/10/2022 11:00:00 AM
Update time03/16/2023 2:57:36 AM
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