ArticleFrontiers in immunology2023
The neutrophil-lymphocyte ratio predicts all-cause and cardiovascular mortality among U.S. adults with rheumatoid arthritis: results from NHANES 1999-2020.
Article in Frontiers in immunology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 3 of them syntheses that pooled it.
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Who cites it
56 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Association between neutrophil-to-lymphocyte ratio and the prognosis of patients with rheumatoid arthritis: a meta-analysis.Frontiers in immunology · 2026Pooled it
- Predictive and prognostic value of the neutrophil-to-lymphocyte ratio for acute kidney injury: a systematic review and meta-analysis.Clinical and experimental medicine · 2025Pooled it
- The predictive role of peripheral serum inflammatory markers NLR, PLR, and LMR in ulcerative colitis and Crohn's disease: a systematic review and meta-analysis.Frontiers in immunology · 2025Pooled it
- Inflammatory and Cardiovascular Responses to Active and Passive Acute Psychological Stress.Biopsychosocial science and medicineTrial
- Comparison and validation of systemic immune-inflammation index, C-reactive protein/albumin ratio, and C-reactive protein-albumin-lymphocyte index for assessing disease activity in rheumatoid arthritis.Clinical rheumatology · 2026Article
- Article
- The neutrophil-to-lymphocyte ratio: a psychoneuroimmunological nexus linking depression and cardiovascular comorbidity.European archives of psychiatry and clinical neuroscience · 2026Article
- Social determinants of health and sarcopenia in adults: Insights from the National Health and Nutrition Examination Survey.Medicine · 2026Article
- Review
- Metabolic and neuroimmune control of rheumatoid arthritis: therapeutic implications of FXR and α7-nAChR axes.Inflammopharmacology · 2026Review
- Article
- Female reproductive status and ecological conditions impact the magnitude of sex differences in human immune status across the lifespan.Research square · 2026Article
- The Relation Between the Aggregate Index of Systemic Inflammation and the Mortality Rate of Cardiovascular Disease in the Elderly Population.Anatolian journal of cardiology · 2026Article
- Utility of CBC-derived ratios in the diagnosis and prediction of active tuberculosis in people with rheumatic diseases.BMC infectious diseases · 2026Article
- Effects of age and sex on all-cause mortality among NHANES participants with metabolic syndrome and rheumatoid arthritis.BMC cardiovascular disorders · 2026Article
- Preoperative LDL-C and mortality after cardiac valve surgery: a retrospective cohort study on the mediating role of inflammatory risk.Lipids in health and disease · 2026Article
- Systemic inflammatory markers in gastric ulcer: Leveraging routine blood tests.World journal of gastroenterology · 2026Article
- The neutrophil-to-lymphocyte ratio as a predictor of all-cause mortality in individuals with anemia: A population-based study.PloS one · 2026Article
- CBC‑derived inflammatory indices for rheumatoid arthritis diagnosis and activity assessment: differential performance by serostatus.Frontiers in immunology · 2026Article
- The neutrophil-to-lymphocyte ratio is associated with adverse outcomes in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis.Frontiers in immunology · 2026Article
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4 authors.
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Abstract
Background: The neutrophil-to-lymphocyte ratio (NLR) is recognized as a biomarker for systemic inflammation and immune activation. However, its connection with the mortality risk in individuals with rheumatoid arthritis (RA) is not well understood. This study aimed to investigate the association between NLR and all-cause and cardiovascular mortality risk in U.S. adults with RA. Methods: Data were gathered from the National Health and Nutrition Examination Survey (NHANES) cycles spanning 1999 to March 2020. We included adults aged ≥20 years. The NLR was computed by dividing the neutrophil count by the lymphocyte count from complete blood counts. The maximally selected rank statistics method helped identify the optimal NLR cutoff value associated with significant survival outcomes. Multivariable logistic regression models were performed to investigate the relationship between the NLR and the all-cause and cardiovascular mortality of RA. Restricted cubic spline (RCS) analyses were utilized to detect whether there were linear or non-linear relationships between NLR and mortality. Results: In this study, 2002 adults with RA were included, with 339 having a higher NLR (≥3.28) and 1663 having a lower NLR (<3.28). During a median follow-up of 84 months, 79 RA individuals died. Participants with higher NLR had a 2-fold increased risk of all-cause (HR = 2.02, 95% CI: 1.53-2.66) and cardiovascular mortality (HR = 2.48, 95% CI: 1.34-4.57) versus lower NLR, after adjusting for demographics, socioeconomic status, and lifestyle factors. Kaplan-Meier analysis revealed that the survival rate for the higher NLR group was significantly lower than the lower NLR group, in terms of both all-cause and cardiovascular mortality (both P<0.0001). The RCS curve demonstrated a positive linear association between the NLR and all-cause and cardiovascular mortality. Conclusion: A higher NLR was independently predictive of elevated long-term mortality risk in U.S. adults with RA. The NLR may serve as an inexpensive, widely available prognostic marker in RA.
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