In an earlier post, based on data from the Baltimore Longitidunal Study on Aging (BLSA), I suggested that total white blood cell (WBCs) counts between 3500 to 6000 cells per microliter of blood may be optimal for reducing disease risk and for maximizing longevity (https://michaellustgarten.com/2015/08/13/blood-testing-whats-optimal-for-wbc-levels/).

However, within WBCs, neutrophils increase, whereas lymphocytes decrease during aging (Ruggiero et al. 2007, Starr and Dreary 2011). As a result, the ratio between neutrophils with lymphocytes (NLR) increases during aging from ~1.5 in 20 year olds to ~1.8 in adults older than 75y (Li et al. 2015):

An increased neutrophil/lymphocyte ratio during aging may be bad for health and disease risk. First, a higher neutrophil/lymphocyte ratio is associated with sarcopenia (defined as the age-related loss of muscle mass and physical function) in older adults (average age, 72y; Öztürk et al. 2018):

Second, risk of death for all causes is significantly increased for older adults (average age, 66y) that had higher NLR values (60-80%, >80%, equivalent to NLR = 1.92-2.41, > 2.41), when compared with lower NLR values (< 20%, 20-40%, 40-60%, equivalent to NLR < 1.90; Fest et al. 2019):

Similarly, all-cause mortality risk was 30% increased in older adults (average age, 54y) that had NLR values > 1.77, when compared with < 1.77, and 40% increased for NLR values > 2.15, when compared with < 2.15 (Kime et al. 2018).

What are my NLR values? Over 17 blood test measurements from 2015 – 2019, my average NLR is 1.11. So far so good!

If you’re interested, please have a look at my book!

References

Fest J, Ruiter TR, Groot Koerkamp B, Rizopoulos D, Ikram MA, van Eijck CHJ, Stricker BH. The neutrophil-to-lymphocyte ratio is associated with mortality in the general population: The Rotterdam Study. Eur J Epidemiol. 2019 May;34(5):463-470.

Kim S, Eliot M, Koestler DC, Wu WC, Kelsey KT. Association of Neutrophil-to-Lymphocyte Ratio With Mortality and Cardiovascular Disease in the Jackson Heart Study and Modification by the Duffy Antigen Variant. JAMA Cardiol. 2018 Jun 1;3(6):455-462. doi: 10.1001/jamacardio.2018.1042.

Li J, Chen Q, Luo X, Hong J, Pan K, Lin X, Liu X, Zhou L, Wang H, Xu Y, Li H, Duan C. Neutrophil-to-Lymphocyte Ratio Positively Correlates to Age in Healthy Population. J Clin Lab Anal. 2015 Nov;29(6):437-43. doi: 10.1002/jcla.21791.

Öztürk ZA, Kul S, Türkbeyler İH, Sayıner ZA, Abiyev A. Is increased neutrophil lymphocyte ratio remarking the inflammation in sarcopenia? Exp Gerontol. 2018 Sep;110:223-229.

Ruggiero C, Metter EJ, Cherubini A, Maggio M, Sen R, Najjar SS, Windham GB, Ble A, Senin U, Ferrucci L. White blood cell count and mortality in the Baltimore Longitudinal Study of Aging. J Am Coll Cardiol. 2007 May 8;49(18):1841-50.

Starr JM, Deary IJ. Sex differences in blood cell counts in the Lothian Birth Cohort 1921 between 79 and 87 years. Maturitas. 2011 Aug;69(4):373-6.

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