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. 2024 Jul 31:12:1427546.
doi: 10.3389/fpubh.2024.1427546. eCollection 2024.

Association between complete blood count-derived inflammatory markers and the risk of frailty and mortality in middle-aged and older adults

Yu Tang #  1 , Ying Zhai #  1 , Wenjing Song  1 , Tengxiao Zhu  1 , Zichen Xu  1 , Luqing Jiang  1 , Lei Li  1 , Daoqin Liu  2 , Qiwen Wu  1
Affiliations

Association between complete blood count-derived inflammatory markers and the risk of frailty and mortality in middle-aged and older adults

Yu Tang et al. Front Public Health. .

Abstract

Objective: This study aimed to evaluate the association between six complete blood count (CBC)-derived inflammatory markers [neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI), and pan-immune inflammation value (PIV)] and the risk of frailty and mortality.

Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Mortality was identified using the National Death Index until December 31, 2019. Multiple logistic regression analysis was conducted to evaluate the association between six CBC-derived inflammatory markers and frailty. The Cox regression model assessed the association between six CBC-derived inflammatory markers and mortality in frail populations. Restricted cubic spline (RCS) was used to visualize the association of the six CBC-derived inflammatory markers with mortality risk. The predictive value of CBC-derived inflammatory markers for mortality was further assessed using a random survival forest (RSF) approach.

Results: This study analyzed data from a total of 16,705 middle-aged and older participants. Among them, 6,503 participants were frail, with a mortality rate of 41.47%. Multiple logistic regression analysis showed that NLR, MLR, PLR, SII, SIRI, and PIV were positively associated with frailty risk. The Cox regression model revealed that participants in the highest quartile had a significantly increased risk of death compared to those in the lowest quartile: NLR (HR = 1.73, 95% CI:1.54, 1.94), MLR (HR = 1.71, 95% CI:1.51, 1.93), PLR (HR = 1.28, 95%CI: 1.15, 1.43), SII (HR = 1.50, 95%CI:1.34, 1.68), SIRI (HR = 1.88, CI 95%:1.67, 2.12), PIV (HR = 1.55, 95%CI:1.38, 1.73). Random survival forest (RSF) analyses demonstrated that MLR had the highest predictive value for mortality risk middle-aged and older adult frail participants.

Conclusion: The results suggest that CBC-derived inflammatory markers are associated with a higher risk of frailty as well as mortality in the middle and old-aged population of the United States.

Keywords: CBC-derived inflammatory markers; NHANES; RSF; frailty; mortality.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Restricted cubic spline analyses the association of complete blood cell count (CBC)-derived indicators (A: NLR; B: MLR; C: PLR; D: SII; E: SIRI; F: PIV) with all-cause mortality in middle-aged and older adult populations with frailty. Adjusted for adjusted for age, gender, race, marital status, education level, family poverty income ratio, body mass index, smoking status, and alcohol status.
Figure 2
Figure 2
Restricted cubic spline analyses the association of complete blood cell count (CBC)-derived indicators (A: NLR; B: MLR; C: PLR; D: SII; E: SIRI; F: PIV) with all-cause mortality in middle-aged and older adult populations with pre-frailty. Adjusted for adjusted for age, gender, race, marital status, education level, family poverty income ratio, body mass index, smoking status, and alcohol status.
Figure 3
Figure 3
Prognostic value of complete blood cell count (CBC)-derived indicators. A random survival forest method was used to compare the value of CBC parameters and CBC-derived inflammatory markers in predicting all-cause mortality in middle-aged and older adult populations with frailty (A) and pre-frailty (B).
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