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The following is a summary of “Associations of neutrophil/high-density lipoprotein cholesterol ratio with frailty and its mortality,” published in the January 2025 issue of Endocrinology by Zhang.

Frailty is increasingly recognized as a critical determinant of health, particularly within the field of critical care medicine, where its identification holds significant clinical importance. Despite its relevance, the swift and accurate identification of frailty remains challenging. This study evaluates the potential of the neutrophil/high-density lipoprotein cholesterol ratio (NHR) as a predictor of frailty and its association with long-term survival. Using data from seven cycles of the National Health and Nutrition Examination Survey (NHANES), researchers included 34,382 adult participants with an average age of 47.6 years, of whom 48.8% were males. Frailty was assessed using a comprehensive 49-item Frailty Index (FI). The analysis employed weighted logistic regression, restricted cubic spline (RCS), and Cox regression to investigate the relationship between NHR and frailty, as well as its impact on long-term survival. Subgroup and interaction analyses were also conducted to explore the robustness of the findings across different populations.

The results revealed that an increase of one standard deviation (SD) in NHR was associated with an 11% higher likelihood of frailty (odds ratio [OR]: 1.11, 95% CI: 1.04-1.18, P = 0.002), even after adjusting for potential confounders. The RCS analysis demonstrated a J-shaped association between NHR and frailty, a relationship that remained consistent across various subgroups. Furthermore, survival analysis highlighted a significant positive association between NHR and mortality risks in frail individuals. Specifically, NHR was linked to increased all-cause mortality (hazard ratio [HR]: 1.12, 95% CI: 1.07-1.17, P < 0.0001), cardiocerebrovascular disease-specific mortality (HR: 1.21, 95% CI: 1.11-1.33, P < 0.0001), and cancer-specific mortality (HR: 1.13, 95% CI: 1.07-1.19, P < 0.0001).

In conclusion, this study establishes a J-shaped relationship between NHR and frailty in the American adult population, suggesting that NHR could serve as a valuable predictor for frailty and its associated long-term mortality risks. These findings underscore the potential of NHR as a practical tool in the early identification and management of frailty, thereby contributing to improved patient outcomes in critical care settings.

Source: frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1495139/full