Normal Values of Neutrophil-to-lymphocyte Ratio, Lymphocyte-to-monocyte Ratio and Platelet-to-lymphocyte Ratio Among Iranian Population: Results of Tabari Cohort

Overview

Journal Caspian J Intern Med

Specialty General Medicine

Date 2019 Sep 28

PMID 31558995

Citations 20

Authors

Mahmood Moosazadeh

Iradj Maleki

Reza Alizadeh-Navaei

Motahareh Kheradmand

Akbar Hedayatizadeh-Omran

Amir Shamshirian

Agil Barzegar

Affiliations

Soon will be listed here.

Abstract

Background: Neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR) and platelet-lymphocyte ratio (PLR) have a prognostic value in several types of diseases such as cancers and they vary in different races. So, we aimed to evaluate the normal range of these markers among healthy people to determine the normal value in Iranian population.

Methods: In the present study, cross-sectional data of population-based cohort study named "Tabari cohort study" was utilized. In the first phase of Tabari cohort, 10255 participants aged 35-70 years from urban and rural areas of Sari, Mazandaran, Iran entered into the study. The study included a questionnaire survey and blood collection. Blood samples were collected after 12 hours fasting from all participants during the study. Hematological indices were measured for all samples using Celltac Alpha MEK-6510 K (Tokyo, Japan).

Results: After sample exclusion, 2212 healthy subjects of Tabari's normal cohort population were investigated. The mean age of the samples was 47.9±9.29 years. The mean of NLR, LMR, PLR were 1.70±0.70, 11.15±3.14 and 117.05±47.73, respectively.

Conclusion: Our investigation provides preliminary reference values for NLR, LMR, and PMR among Iranian population that can be used for disease progress in various clinical procedures.

Citing Articles

Predictors of cytomegalovirus infection in patients with connective tissue disease treated by pulsed methylprednisolone therapy: a multicenter retrospective cohort study.

Ito H, Yoshimoto T, Kokaze A, Wakabayashi K, Noguchi K, Matsui K BMC Infect Dis. 2025; 25(1):137.

PMID: 39875823 PMC: 11776137. DOI: 10.1186/s12879-025-10543-z.

The Role of Complete Blood Count-Derived Inflammatory Biomarkers as Predictors of Infection After Acute Ischemic Stroke: A Single-Center Retrospective Study.

Rinawati W, Machin A, Aryati A Medicina (Kaunas). 2025; 60(12.

PMID: 39768955 PMC: 11679367. DOI: 10.3390/medicina60122076.

Complete Blood Cell Count-Derived Inflammation Biomarkers and the Need for Laser Capsulotomy Due to Posterior Capsule Opacification Following Cataract Surgery.

Uzun F, Aydin E, Akgoz H, Aslan M J Inflamm Res. 2024; 17:6075-6082.

PMID: 39253563 PMC: 11382797. DOI: 10.2147/JIR.S473655.

Evaluation of THP-1 and Jurkat Cell Lines Coculture for the In Vitro Assessment of the Effects of Immunosuppressive Substances.

Franko N, Dolenc M Toxics. 2024; 12(8).

PMID: 39195709 PMC: 11358983. DOI: 10.3390/toxics12080607.

The predictors of coronary slow flow in patients undergoing coronary angiography.

Ermawan R, Pintaningrum Y, Indrayana Y Egypt Heart J. 2024; 76(1):103.

PMID: 39136846 PMC: 11322457. DOI: 10.1186/s43044-024-00536-9.

References

Allavena P, Sica A, Solinas G, Porta C, Mantovani A . The inflammatory micro-environment in tumor progression: the role of tumor-associated macrophages. Crit Rev Oncol Hematol. 2007; 66(1):1-9. DOI: 10.1016/j.critrevonc.2007.07.004. View

Mantovani A, Allavena P, Sica A, Balkwill F . Cancer-related inflammation. Nature. 2008; 454(7203):436-44. DOI: 10.1038/nature07205. View

Hung H, Chen J, Yeh C, Changchien C, Tang R, Hsieh P . Effect of preoperative neutrophil-lymphocyte ratio on the surgical outcomes of stage II colon cancer patients who do not receive adjuvant chemotherapy. Int J Colorectal Dis. 2011; 26(8):1059-65. DOI: 10.1007/s00384-011-1192-x. View

Sharaiha R, Halazun K, Mirza F, Port J, Lee P, Neugut A . Elevated preoperative neutrophil:lymphocyte ratio as a predictor of postoperative disease recurrence in esophageal cancer. Ann Surg Oncol. 2011; 18(12):3362-9. PMC: 3192937. DOI: 10.1245/s10434-011-1754-8. View

Azab B, Bhatt V, Phookan J, Murukutla S, Kohn N, Terjanian T . Usefulness of the neutrophil-to-lymphocyte ratio in predicting short- and long-term mortality in breast cancer patients. Ann Surg Oncol. 2011; 19(1):217-24. DOI: 10.1245/s10434-011-1814-0. View

Proctor M, Morrison D, Talwar D, Balmer S, Fletcher C, OReilly D . A comparison of inflammation-based prognostic scores in patients with cancer. A Glasgow Inflammation Outcome Study. Eur J Cancer. 2011; 47(17):2633-41. DOI: 10.1016/j.ejca.2011.03.028. View

Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G . Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2012; 11(1):55-9. DOI: 10.1586/erc.12.159. View

Gulati G, Song J, Florea A, Gong J . Purpose and criteria for blood smear scan, blood smear examination, and blood smear review. Ann Lab Med. 2013; 33(1):1-7. PMC: 3535191. DOI: 10.3343/alm.2013.33.1.1. View

Elinav E, Nowarski R, Thaiss C, Hu B, Jin C, Flavell R . Inflammation-induced cancer: crosstalk between tumours, immune cells and microorganisms. Nat Rev Cancer. 2013; 13(11):759-71. DOI: 10.1038/nrc3611. View

10.

McFarlane A, Aslan B, Raby A, Bourner G, Padmore R . Critical values in hematology. Int J Lab Hematol. 2014; 37(1):36-43. DOI: 10.1111/ijlh.12226. View

11.

Hutterer G, Stoeckigt C, Stojakovic T, Jesche J, Eberhard K, Pummer K . Low preoperative lymphocyte-monocyte ratio (LMR) represents a potentially poor prognostic factor in nonmetastatic clear cell renal cell carcinoma. Urol Oncol. 2014; 32(7):1041-8. DOI: 10.1016/j.urolonc.2014.04.001. View

12.

Azab B, Camacho-Rivera M, Taioli E . Average values and racial differences of neutrophil lymphocyte ratio among a nationally representative sample of United States subjects. PLoS One. 2014; 9(11):e112361. PMC: 4223021. DOI: 10.1371/journal.pone.0112361. View

13.

Nishijima T, Muss H, Shachar S, Tamura K, Takamatsu Y . Prognostic value of lymphocyte-to-monocyte ratio in patients with solid tumors: A systematic review and meta-analysis. Cancer Treat Rev. 2015; 41(10):971-8. DOI: 10.1016/j.ctrv.2015.10.003. View

14.

Kweon O, Lee M, Kim H, Chung J, Choi S, Kim H . Neutropenia and neutrophil-to-lymphocyte ratio in a healthy Korean population: race and sex should be considered. Int J Lab Hematol. 2016; 38(3):308-18. DOI: 10.1111/ijlh.12489. View

15.

Ding N, Pang Z, Shen H, Ni Y, Du J, Liu Q . The Prognostic Value of PLR in Lung Cancer, a Meta-analysis Based on Results from a Large Consecutive Cohort. Sci Rep. 2016; 6:34823. PMC: 5050506. DOI: 10.1038/srep34823. View

16.

Dalpiaz O, Krieger D, Ehrlich G, Pohlmann K, Stojakovic T, Pummer K . Validation of the Preoperative Platelet-to-Lymphocyte Ratio as a Prognostic Factor in a European Cohort of Patients with Upper Tract Urothelial Carcinoma. Urol Int. 2016; 98(3):320-327. DOI: 10.1159/000452109. View

17.

Zhu Y, Si W, Sun Q, Qin B, Zhao W, Yang J . Platelet-lymphocyte ratio acts as an indicator of poor prognosis in patients with breast cancer. Oncotarget. 2016; 8(1):1023-1030. PMC: 5352031. DOI: 10.18632/oncotarget.13714. View

18.

Forget P, Khalifa C, Defour J, Latinne D, Van Pel M, De Kock M . What is the normal value of the neutrophil-to-lymphocyte ratio?. BMC Res Notes. 2017; 10(1):12. PMC: 5217256. DOI: 10.1186/s13104-016-2335-5. View

19.

Wu Q, Hu T, Zheng E, Deng X, Wang Z . Prognostic role of the lymphocyte-to-monocyte ratio in colorectal cancer: An up-to-date meta-analysis. Medicine (Baltimore). 2017; 96(22):e7051. PMC: 5459731. DOI: 10.1097/MD.0000000000007051. View

20.

Lieto E, Galizia G, Auricchio A, Cardella F, Mabilia A, Basile N . Preoperative Neutrophil to Lymphocyte Ratio and Lymphocyte to Monocyte Ratio are Prognostic Factors in Gastric Cancers Undergoing Surgery. J Gastrointest Surg. 2017; 21(11):1764-1774. DOI: 10.1007/s11605-017-3515-x. View