Observational studyBMC pulmonary medicine2018
Clinical utility of blood neutrophil-lymphocyte ratio in Japanese COPD patients.
Observational study in BMC pulmonary medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictors of Acute Exacerbations in COPD: A Systematic Review.International journal of chronic obstructive pulmonary disease · 2026Pooled it
- The relationship of Systemic Inflammatory Index with asthma in adults: A retrospective cross-sectional study.The Journal of international medical research · 2025Article
- Relationship between systemic immune response index (SIRI) and COPD: a cross-sectional study based on NHANES 2007-2012.Scientific reports · 2025Article
- Association of neutrophil-to-lymphocyte ratio and CRP with spirometry in COPD patients in North India.Journal of family medicine and primary care · 2025Article
- NHANES-based assessment of neutrophil-percentage-to-albumin and neutrophil-to-lymphocyte ratios as moderate predictors of mortality in adults with chronic respiratory diseases.Frontiers in pharmacology · 2025Article
- Predictive value of blood routine-derived inflammation indexes for varicella-zoster virus meningitis in patients with acute herpes zoster.Frontiers in cellular and infection microbiology · 2025Article
- Article
- The Neutrophil-to-Lymphocyte Ratio as a Predictor of Acute Exacerbations Among Patients With COPD in Uganda.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2024Article
- The association of systemic immune-inflammation index with lung function, risk of COPD and COPD severity: A population-based study.PloS one · 2024Article
- Use of the Serum Level of Cholinesterase as a Prognostic Marker of Nonfatal Clinical Outcomes in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease.Canadian respiratory journal · 2024Article
- Review
- Association Between Neutrophil-Lymphocyte Ratio and All-Cause Mortality in Critically Ill Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study.Medical science monitor : international medical journal of experimental and clinical research · 2023Article
- Serum Amyloid A in Stable Patients with Chronic Obstructive Pulmonary Disease Does Not Reflect the Clinical Course of the Disease.International journal of molecular sciences · 2023Article
- Diagnostic and prognostic biomarkers for progressive fibrosing interstitial lung disease.PloS one · 2023Article
- Article
- Clinical Utility of the Electrocardiographic P-Wave Axis in Patients with Chronic Obstructive Pulmonary Disease.Respiration; international review of thoracic diseases · 2022Observational
- The mechanistic role of neutrophil lymphocyte ratio perturbations in the leading non communicable lifestyle diseases.F1000Research · 2022Review
- Association Between Serum Sodium and Long-Term Mortality in Critically Ill Patients with Comorbid Chronic Obstructive Pulmonary Disease: Analysis from the MIMIC-IV Database.International journal of chronic obstructive pulmonary disease · 2022Article
- Diagnostic Value of the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) in Various Respiratory Diseases: A Retrospective Analysis.Diagnostics (Basel, Switzerland) · 2021Article
- Neutrophil-to-lymphocyte ratio, blood eosinophils and COPD exacerbations: a cohort study.ERJ open research · 2021Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeutrophil-to-lymphocyte ratio (NLR) is a biomarker of inflammation in chronic obstructive pulmonary disease (COPD) patients. But, a meaningful threshold and the longitudinal changes are unknown. We aimed to investigate the association between NLR and the clinical characteristics of COPD patients and to determine a meaningful threshold and the longitudinal changes for NLR.
methodsKeio University and its affiliate hospitals conducted an observational COPD cohort study over 3 years. We performed a blood examination and a pulmonary function test. Blood examination was completed at baseline and annually thereafter, at a time when the disease was stable. Two hundred seventy-four patients who had at least 3 blood examinations over 3 years were included.
resultsBaseline NLR was correlated with baseline C-reactive protein (CRP) (r = 0.18, p = 0.003) and SAA (r = 0.34, p < 0.001). We defined an NLR score of 2.7 as the arbitrary cut-off value based on upper quartile points. COPD patients with NLR ≥ 2.7 were older (p = 0.037), had a lower BMI (p = 0.005) and a lower %FEV1 (p = 0.0003) compared to patients with NLR < 2.7. Receiver-operating-characteristic (ROC) curves showed the optimal cutoff for the baseline NLR in the predicting moderate/severe exacerbation to be 2.7, which was same as the upper quartile points. Follow-up analysis over 3 years revealed that the differences in the trends of NLR among the three groups based on the categories of exacerbations (moderate or severe, mild, no exacerbation) were significant (p = 0.006).
conclusionsNLR is associated with COPD severity and exacerbations. For predicting exacerbations, we estimated the threshold of NLR to be 2.7 at baseline.
trial registrationClinical trial registered with the University Hospital Medication Information Network ( UMIN000003470 , April 10, 2010).
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