Biomarkers · Inflammation
Neutrophil-to-Lymphocyte Ratio (NLR)
Lower values carry lower risk. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation is associated with a hazard ratio of 1.22. Reproduces in NHANES
NHANES, our fit with 95% CIPublished curve
Hazard ratios relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.
NHANES hazard per SD1.2295% CI 1.19–1.25 · 48,955 adults, 7,151 deaths
Published hazard ratio1.64top vs bottom quarter (95% CI 1.45–1.85) · Rotterdam Study Population Cohort
Where people sit
Population percentiles (ratio) by sex and age band. Cycle or source as recorded in the catalogue.
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 1.00 | 1.38 | 1.74 | 2.22 | 3.75 | 2,680 | 2017-2018 |
| All | 40-59 | 1.05 | 1.47 | 1.89 | 2.47 | 4.40 | 2,630 | 2017-2018 |
| All | 60+ | 1.12 | 1.60 | 2.08 | 2.78 | 5.15 | 2,790 | 2017-2018 |
| All | all | 1.05 | 1.48 | 1.90 | 2.48 | 4.45 | 8,100 | 2017-2018 |
| Men | all | 1.06 | 1.50 | 1.92 | 2.52 | 4.55 | 3,930 | 2017-2018 |
| Women | all | 1.04 | 1.46 | 1.88 | 2.44 | 4.35 | 4,170 | 2017-2018 |
What studies found when this marker was changed
Effects on the biomarker reported in the cited studies. They describe what happened in those populations, not a recommendation for anyone. See all catalogued interventions.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| behavioral | Comprehensive stress reduction and mindfulness-based stress intervention | -10% to -25% reduction | rct | Black DS, et al. Psychoneuroendocrinology. 2016;63:342-351. |
| clinical | Severe Sepsis, Acute Bacterial Infection, or Critical Care Shock | +150% to +500% elevation (NLR > 5.0) | meta-analysis | Zahorec R. Bratisl Lek Listy. 2001;102:5-14. |
| exercise | Supervised combined endurance and resistance exercise | Reduces NLR by 0.3-0.7 toward optimal reference (<2.0) | RCT | Estruch R, et al. Primary Prevention of Cardiovascular Disease with a Mediterran… |
| exercise | Aerobic endurance training and cardiovascular conditioning | -15% to -30% reduction towards optimal ratio | rct | Nieman DC, et al. Sports Med. 2019;49:29-37. |
| nutraceutical | Anti-inflammatory botanical extracts (Green Tea EGCG / Curcumin) | -10% to -20% reduction | meta-analysis | Farhadi A, et al. Phytomedicine. 2021;85:153549. |
| sleep | Chronic severe psychological burnout and sleep disruption | +25% to +50% elevation | prospective cohort | Gidron Y, et al. Brain Behav Immun. 2020;87:21-23. |
Sources
- Hazard curve: J Am Coll Cardiol 2014; 63:2260
- Fest J, et al. The systemic inflammation markers NLR and PLR and all-cause mortality: the Rotterdam Study. Cancer Epidemiol Biomarkers Prev. 2018;27(7):735-741.
- Empirical curve: our Cox model with age and sex, NHANES 1999–2018 with linked mortality to 2019.
Map Neutrophil-to-Lymphocyte Ratio (NLR) against another biomarker.