Utility of neutrophil to lymphocyte ratio in the prediction of inflammation and COPD mortality

Dimic-Janjic, Sanja (58019271900)Sanja (58019271900)Dimic-JanjicZecevic, Andrej (58846253100)Andrej (58846253100)ZecevicGolubovic, Aleksa (58258139500)Aleksa (58258139500)GolubovicRatkovic, Ana (58541092000)Ana (58541092000)RatkovicMilivojevic, Ivan (58150217900)Ivan (58150217900)MilivojevicPostic, Anka (59926371000)Anka (59926371000)PosticStjepanovic, Mihailo (55052044500)Mihailo (55052044500)StjepanovicJankovic, Jelena (57211575577)Jelena (57211575577)JankovicTrboljevac, Nikola (57722831100)Nikola (57722831100)TrboljevacBarac, Aleksandra (55550748700)Aleksandra (55550748700)BaracPopevic, Spasoje (54420874900)Spasoje (54420874900)PopevicSamardzic, Ana (57208631860)Ana (57208631860)SamardzicIsovic, Lidija (59927041800)Lidija (59927041800)IsovicMilenkovic, Branislava (23005307400)Branislava (23005307400)Milenkovic2025-07-022025-07-022025https://doi.org/10.3855/jidc.20466https://www.scopus.com/inward/record.uri?eid=2-s2.0-105007169204&doi=10.3855%2fjidc.20466&partnerID=40&md5=fb14e77b431115c6672804a71f2a157bhttps://remedy.med.bg.ac.rs/handle/123456789/11419Introduction: The Neutrophil-to-Lymphocyte Ratio (NLR) has been utilized to predict clinical outcomes in cardiovascular diseases, infectious diseases, and solid tumors and it has a potential association with the severity of Chronic Obstructive Pulmonary Disease (COPD). This study aimed to determine whether NLR is a possible predictor of inflammation severity and mortality in COPD. Methodology: A prospective analysis of NLR in 70 COPD patients, and its relation with biochemical, lung function parameters, and mortality was assessed. Results: NLR was negatively associated with oxygen saturation (p < 0.05) and positively related to C-reactive protein (CRP) (p < 0.05), matrix metalloproteinase-9 (MMP-9) (p ≤ 0.001), tissue inhibitor of metalloproteinase-1 (TIMP-1) (p < 0.05), MMP-9/TIMP-1 ratio (p < 0.05), and the modified Medical Research Council dyspnea scale (mMRC) score (p < 0.05). Deceased patients had significantly higher NLR (p < 0.05). Older age and lower levels of saturation were independently associated with higher mortality in COPD patients (p < 0.05). Conclusions: NLR in COPD correlates with inflammation and protease/antiprotease balance, with elevated NLR detected in deceased patients. These findings suggest that NLR can be a helpful clinical marker in COPD. Copyright © 2025 Dimic-Janjic et al.COPDinflammationmortalityNeutrophil-to-Lymphocyte RatioUtility of neutrophil to lymphocyte ratio in the prediction of inflammation and COPD mortality