Table_1_Association Between Neutrophil–Lymphocyte Ratio and Frailty: The Chinese Longitudinal Healthy Longevity Survey.DOCX

Background: Inflammation has been reported to play an important role in frailty syndrome. The neutrophil–lymphocyte ratio (NLR) has recently emerged as an informative marker for systematic inflammation. However, few studies have examined the association between NLR and frailty. This study aims to examine the association between NLR and frailty in community-dwelling older adults.
Methods: Community-dwelling older adults aged ≥ 65 years in the 2011 (n = 2,354) and 2014 (n = 2,458) waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included. Frailty status was determined using the 38-item frailty index (FI) and categorized into “robust” (FI ≤ 0.1), “pre-frail” (0.1 < FI ≤ 0.21), or “frail” (FI > 0.21). NLR was calculated using a derived formula: NLR = (white blood cell–lymphocyte)/lymphocyte.
Results: A total of 3,267 participants were finally included. In cross-sectional analyses, participants with higher NLR levels had increased likelihood of frailty [the 3rd quartile: adjusted odds ratio (OR) = 1.29; 95% confidence interval (CI): 1.02–1.63; the 4th quartile: OR = 1.59; 95% CI: 1.23–2.02) compared with those in the 1st quartile group. During the 3-year follow-up, 164 of the 1,206 participants, robust or pre-frail at baseline, developed frailty, and 197 of the 562 participants, robust at baseline, developed pre-frailty or frailty. Among the robust and pre-frail participants in 2011, after multivariate adjustment, those in the 4th quartile group had a higher frailty incidence than those in the 1st quartile group (OR = 2.06; 95% CI: 1.18–3.59). Among the robust participants in 2011, those in the 4th quartile group also had a higher pre-frailty or frailty incidence than those in the 1st quartile group (OR = 1.95; 95% CI: 1.07–3.55).
Conclusion: Among community-dwelling older adults, higher NLR levels were found to be associated with increased odds of prevalent and incident frailty.

背景：已有研究证实，炎症在衰弱综合征的发病机制中发挥关键作用。中性粒细胞-淋巴细胞比值（neutrophil–lymphocyte ratio, NLR）作为反映全身性炎症的有效生物标志物，近年来受到广泛关注。然而，目前针对NLR与衰弱相关性的研究仍较为匮乏。本研究旨在探究社区居住老年人群中NLR与衰弱的关联。
研究对象与方法：本研究纳入中国老年健康与长寿追踪调查（CLHLS）2011年轮次（n=2354）及2014年轮次（n=2458）中年龄≥65岁的社区居住老年人。采用38项衰弱指数（frailty index, FI）评估研究对象的衰弱状态，并将其分为健壮组（FI≤0.1）、衰弱前期组（0.1<FI≤0.21）及衰弱组（FI>0.21）。NLR通过推导公式计算：NLR=(白细胞计数-淋巴细胞计数)/淋巴细胞计数。
研究结果：最终共纳入3267名研究对象。横断面分析结果显示，与第1四分位组相比，NLR水平较高的研究对象发生衰弱的风险显著升高[第3四分位组：校正后比值比（odds ratio, OR）=1.29；95%置信区间（confidence interval, CI）：1.02~1.63；第4四分位组：OR=1.59；95%CI：1.23~2.02]。在3年随访期间，基线状态为健壮或衰弱前期的1206名研究对象中，共有164人进展为衰弱；基线状态为健壮的562名研究对象中，共有197人进展为衰弱前期或衰弱。对2011年基线时健壮及衰弱前期的研究对象进行多因素校正后分析显示，第4四分位组研究对象的衰弱发生率显著高于第1四分位组（OR=2.06；95%CI：1.18~3.59）。对2011年基线时仅为健壮的研究对象进行亚组分析显示，第4四分位组研究对象的衰弱前期或衰弱发生率同样显著高于第1四分位组（OR=1.95；95%CI：1.07~3.55）。
结论：在社区居住的老年人群中，较高的NLR水平与衰弱的现患率及新发率升高存在显著相关性。