Daniel T Hoesterey, Hong Dang, Daniela Markovic, Russell G Buhr, Donald P Tashkin, R Graham Barr, John A Belperio, Russell P Bowler, Eugene R Bleecker, David J Couper, Gerard G Criner, Christopher B Cooper, Claire M Doerschuk, Mark T Dransfield, M Bradley Drummond, Ashraf Fawzy, Christine M Freeman, MeiLan K Han, Nadia N Hansel, Annette T Hastie, Eric A Hoffman, Yvonne J Huang, Robert J Kaner, Richard E Kanner, Victor Kim, Jerry A Krishnan, Fernando J Martinez, Wanda K O'Neal, Victor E Ortega, Robert Paine, Abhishek K Shrivastav, J Michael Wells, Prescott G Woodruff, Jeffrey L Curtis, Igor Barjaktarevic
{"title":"中性粒细胞与淋巴细胞比率（NLR）作为临床稳定型慢性阻塞性肺疾病的生物标志物：SPIROMICS队列。","authors":"Daniel T Hoesterey, Hong Dang, Daniela Markovic, Russell G Buhr, Donald P Tashkin, R Graham Barr, John A Belperio, Russell P Bowler, Eugene R Bleecker, David J Couper, Gerard G Criner, Christopher B Cooper, Claire M Doerschuk, Mark T Dransfield, M Bradley Drummond, Ashraf Fawzy, Christine M Freeman, MeiLan K Han, Nadia N Hansel, Annette T Hastie, Eric A Hoffman, Yvonne J Huang, Robert J Kaner, Richard E Kanner, Victor Kim, Jerry A Krishnan, Fernando J Martinez, Wanda K O'Neal, Victor E Ortega, Robert Paine, Abhishek K Shrivastav, J Michael Wells, Prescott G Woodruff, Jeffrey L Curtis, Igor Barjaktarevic","doi":"10.1513/AnnalsATS.202412-1265OC","DOIUrl":null,"url":null,"abstract":"<p><strong>Rationale: </strong>Inflammation is central to chronic obstructive pulmonary disease (COPD) pathogenesis but incompletely represented in COPD prognostic models. Neutrophil to lymphocyte ratio (NLR) is a readily available inflammatory biomarker.</p><p><strong>Objectives: </strong>To explore the associations of NLR with smoking status, clinical features of COPD, and future adverse outcomes.</p><p><strong>Methods: </strong>We analyzed NLR calculated from the complete blood count of participants who currently or formerly smoked (n = 2,624) and tobacco-naïve controls (n = 187) in the SPIROMICS multicenter observational cohort study. We assessed the stability of NLR at 6 weeks and 1 year, the association with select blood biomarkers, and the impact of smoking on NLR and cell counts. We stratified participants by NLR quartiles to compare cross-sectional clinical features at enrollment, prospectively observed exacerbations at 1 year, and mortality during longitudinal follow-up.</p><p><strong>Results: </strong>Higher NLR quartiles were broadly associated with more severe clinical features of COPD. NLR values were repeatable at 6 weeks (ICC=0.74) and 1 year (ICC=0.62). The impact of smoking on NLR varied with the severity of airflow limitation, mediated by an interaction between smoking, FEV1 % predicted, and neutrophil counts but not lymphocyte counts. The highest NLR quartile (>3.11) was associated with an increased risk of exacerbation over 1-year (adjusted OR=1.51 95%CI 1.18, 1.92) and increased risk of mortality (adjusted HR=1.41, 95%CI 1.20, 1.66) compared to quartiles 1-3.</p><p><strong>Conclusions: </strong>Elevated NLR in stable COPD is a widely available biomarker associated with increased risk for exacerbation and death. The impact of cigarette smoking on NLR varies with disease severity.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Neutrophil-to-Lymphocyte Ratio (NLR) as a Biomarker in Clinically Stable Chronic Obstructive Pulmonary Disease: SPIROMICS cohort.\",\"authors\":\"Daniel T Hoesterey, Hong Dang, Daniela Markovic, Russell G Buhr, Donald P Tashkin, R Graham Barr, John A Belperio, Russell P Bowler, Eugene R Bleecker, David J Couper, Gerard G Criner, Christopher B Cooper, Claire M Doerschuk, Mark T Dransfield, M Bradley Drummond, Ashraf Fawzy, Christine M Freeman, MeiLan K Han, Nadia N Hansel, Annette T Hastie, Eric A Hoffman, Yvonne J Huang, Robert J Kaner, Richard E Kanner, Victor Kim, Jerry A Krishnan, Fernando J Martinez, Wanda K O'Neal, Victor E Ortega, Robert Paine, Abhishek K Shrivastav, J Michael Wells, Prescott G Woodruff, Jeffrey L Curtis, Igor Barjaktarevic\",\"doi\":\"10.1513/AnnalsATS.202412-1265OC\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Rationale: </strong>Inflammation is central to chronic obstructive pulmonary disease (COPD) pathogenesis but incompletely represented in COPD prognostic models. Neutrophil to lymphocyte ratio (NLR) is a readily available inflammatory biomarker.</p><p><strong>Objectives: </strong>To explore the associations of NLR with smoking status, clinical features of COPD, and future adverse outcomes.</p><p><strong>Methods: </strong>We analyzed NLR calculated from the complete blood count of participants who currently or formerly smoked (n = 2,624) and tobacco-naïve controls (n = 187) in the SPIROMICS multicenter observational cohort study. We assessed the stability of NLR at 6 weeks and 1 year, the association with select blood biomarkers, and the impact of smoking on NLR and cell counts. We stratified participants by NLR quartiles to compare cross-sectional clinical features at enrollment, prospectively observed exacerbations at 1 year, and mortality during longitudinal follow-up.</p><p><strong>Results: </strong>Higher NLR quartiles were broadly associated with more severe clinical features of COPD. NLR values were repeatable at 6 weeks (ICC=0.74) and 1 year (ICC=0.62). The impact of smoking on NLR varied with the severity of airflow limitation, mediated by an interaction between smoking, FEV1 % predicted, and neutrophil counts but not lymphocyte counts. The highest NLR quartile (>3.11) was associated with an increased risk of exacerbation over 1-year (adjusted OR=1.51 95%CI 1.18, 1.92) and increased risk of mortality (adjusted HR=1.41, 95%CI 1.20, 1.66) compared to quartiles 1-3.</p><p><strong>Conclusions: </strong>Elevated NLR in stable COPD is a widely available biomarker associated with increased risk for exacerbation and death. The impact of cigarette smoking on NLR varies with disease severity.</p>\",\"PeriodicalId\":93876,\"journal\":{\"name\":\"Annals of the American Thoracic Society\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of the American Thoracic Society\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1513/AnnalsATS.202412-1265OC\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of the American Thoracic Society","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1513/AnnalsATS.202412-1265OC","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Neutrophil-to-Lymphocyte Ratio (NLR) as a Biomarker in Clinically Stable Chronic Obstructive Pulmonary Disease: SPIROMICS cohort.
Rationale: Inflammation is central to chronic obstructive pulmonary disease (COPD) pathogenesis but incompletely represented in COPD prognostic models. Neutrophil to lymphocyte ratio (NLR) is a readily available inflammatory biomarker.
Objectives: To explore the associations of NLR with smoking status, clinical features of COPD, and future adverse outcomes.
Methods: We analyzed NLR calculated from the complete blood count of participants who currently or formerly smoked (n = 2,624) and tobacco-naïve controls (n = 187) in the SPIROMICS multicenter observational cohort study. We assessed the stability of NLR at 6 weeks and 1 year, the association with select blood biomarkers, and the impact of smoking on NLR and cell counts. We stratified participants by NLR quartiles to compare cross-sectional clinical features at enrollment, prospectively observed exacerbations at 1 year, and mortality during longitudinal follow-up.
Results: Higher NLR quartiles were broadly associated with more severe clinical features of COPD. NLR values were repeatable at 6 weeks (ICC=0.74) and 1 year (ICC=0.62). The impact of smoking on NLR varied with the severity of airflow limitation, mediated by an interaction between smoking, FEV1 % predicted, and neutrophil counts but not lymphocyte counts. The highest NLR quartile (>3.11) was associated with an increased risk of exacerbation over 1-year (adjusted OR=1.51 95%CI 1.18, 1.92) and increased risk of mortality (adjusted HR=1.41, 95%CI 1.20, 1.66) compared to quartiles 1-3.
Conclusions: Elevated NLR in stable COPD is a widely available biomarker associated with increased risk for exacerbation and death. The impact of cigarette smoking on NLR varies with disease severity.
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