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. 2018 Jul 12;8(1):10566.
doi: 10.1038/s41598-018-28646-w.

Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study

Jesse Fest  1   2 , Rikje Ruiter  2 , M Arfan Ikram  2 , Trudy Voortman  2 , Casper H J van Eijck  1 , Bruno H Stricker  3
Affiliations

Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study

Jesse Fest et al. Sci Rep. .

Abstract

Novel prognostic inflammatory markers of cancer survival and cardiovascular disease are; the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR) and the systemic immune-inflammation index (SII). As normal values for these markers are unknown, our objective was to obtain reference values in the general population. We obtained data from a population-based prospective cohort study of individuals aged 45 years and over between 2002 and 2014. Absolute blood counts were used to calculate the NLR, PLR and SII. All inflammatory indices followed a log-normal distribution. We calculated the mean and 95% reference intervals in an unselected population. Furthermore we studied whether the inflammatory markers differed between age categories and gender. In total 8,711 participants (57.1% female; mean age 65.9 years, standard deviation 10.5 years) were included. Mean values and corresponding 95% reference intervals for the NLR were: 1.76 (0.83-3.92), for PLR: 120 (61-239) and for SII: 459 (189-1168). The inflammatory markers increased with age. The PLR and SII were higher in females, whilst the NLR was higher in males. In conclusion, we provided reference values for new inflammatory markers. All increase with age and vary with gender. This provides context that allows for proper interpretation of their potential value in future clinical practice and research.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of the study population.
Figure 2
Figure 2
Distributions of the inflammatory markers in the general population. Panel A. NLR Panel B. PLR Panel C. SII.
See this image and copyright information in PMC

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