Diet and Exercise Improve Neutrophil to Lymphocyte Ratio in Overweight Adolescents

Abstract

Neutrophil to lymphocyte ratio and levels of pro-inflammatory cytokines were evaluated in overweight, male Chinese adolescents upon completing a 4-week diet and physical exercise intervention. 43 recruited, non-randomized adolescents (body mass index >25 kg/m²) completed the controlled study. Anthropometric and biologic parameters were measured pre- and post-intervention. After the 4-week intervention, participants exhibited a significant decrease in body mass, body mass index, percentage body fat, basal heart rate, diastolic blood pressure, and all body shape indices tested. A significant decrease in serum lipids (except high-density lipoprotein cholesterol) and insulin levels was observed post-intervention. The neutrophil to lymphocyte ratio was significantly lower post-intervention. Bivariate correlation analyses showed that decrement in Δneutrophil to lymphocyte ratio significantly correlated with decrement in Δinterleukin-6 and Δwhite blood cell count. Thus, a 4-week diet and physical exercise intervention significantly reduces the neutrophil to lymphocyte ratio in a population of overweight, male adolescents. Weight loss caused by the intervention was associated with a significant decrease of pro-inflammatory cytokine levels.

Key words

obesity - NLR - IL-6 - leukocytes

• References

• 1 Abo T, Kawamura T. Immunomodulation by the autonomic nervous system: therapeutic approach for cancer, collagen diseases, and inflammatory bowel diseases. Ther Apher 2002; 6: 348-357
• 2 Adachi K, Nishijo K, Abo T. Those with the habit of going to sleep early show a higher ratio of lymphocytes while those with the habit of staying up late show a higher ratio of granulocytes. Biomed Res 2010; 31: 143-149
• 3 Abdullah SM, Khera A, Leonard D, Das SR, Canham RM, Kamath SA, Vega GL, Grundy SM, McGuire DK, de Lemos JA. Sex differences in the association between leptin and CRP: results from the Dallas Heart Study. Atherosclerosis 2007; 195: 404-410
• 4 Anderson JW, Allgood LD, Turner J, Oeltgen PR, Daggy BP. Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr 1999; 70: 466-473
• 5 Balagopal P, George D, Patton N, Yarandi H, Roberts WL, Bayne E, Gidding S. Lifestyle-only intervention attenuates the inflammatory state associated with obesity: a randomized controlled study in adolescents. J Pediatr 2005; 146: 342-348
• 6 Bastard JP, Jardel C, Delattre J, Hainque B, Bruckert E, Oberlin F. Evidence for a link between adipose tissue interleukin-6 content and serum C-reactive protein concentrations in obese subjects. Circulation 1999; 99: 2221-2222
• 7 Berg AH, Scherer PE. Adipose tissue, inflammation, and cardiovascular disease. Circ Res 2005; 96: 939-949
• 8 Browning LM, Krebs JD, Magee EC, Frühbeck G, Jebb SA. Circulating markers of inflammation and their link to indices of adiposity. Obes Facts 2008; 1: 259-265
• 9 Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA 2010; 303: 235-241
• 10 Harmse B, Kruger HS. Significant differences between serum CRP levels in children in different categories of physical activity: the PLAY study. Cardiovasc J Afr 2010; 21: 316-322
• 11 Harriss DJ, Atkinson G. Update – Ethical Standards in Sport and Exercise Science Research. Int J Sports Med 2011; 32: 819-821
• 12 Ignarro LJ, Balestrieri ML, Napoli C. Nutrition, physical activity, and cardiovascular disease: an update. Cardiovasc Res 2007; 73: 326-340
• 13 Kim JA, Park HS. White blood cell count and abdominal fat distribution in female obese adolescents. Metab Clin Exp 2008; 57: 1375-1379
• 14 Kishimoto T. IL-6: from its discovery to clinical applications. Int Immunol 2010; 22: 347-352
• 15 Latini G, Gallo F, Iughetti L. Toxic environment and obesity pandemia: is there a relationship?. Ital J Pediatr 2010; 36: 8
• 16 Li HY, Chen PJ, Zhang J. An equation of calculating oxygen consumption of physical activity in obese children and adolescents. The effect of atorvastatin on the expression of CD55, CD59 in patients with hyperlipidemia. Chin J Sports Med 2010; 29: 217-220
• 17 Mifflin St MD, Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO. A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr 1990; 51: 241-247
• 18 Nascimento H, Rocha S, Rego C, Ferreira Mansilha H, Quitanilha A, Santos-Silva A, Belo L. Leukocyte count versus C-reactive protein levels in obese Portuguese patients aged 6–12 years old. Open Biochem J 2010; 4: 72-76
• 19 Nicklas BJ, Ambrosius W, Messier SP, Miller GD, Penninx BWJH, Loeser RF, Palla S, Bleecker E, Pahor M. Diet-induced weight loss, exercise, and chronic inflammation in older, obese adults: a randomized controlled clinical trial. Am J Clin Nutr 2004; 79: 544-551
• 20 Ogden CL, Carroll MD, Curtin LR, Flegal KM. Prevalence of high body mass index in US children and adolescents, 2007–2008. JAMA 2010; 303: 242-249
• 21 Reinehr T, Stoffel-Wagner B, Roth CL, Andler W. High-sensitivity C-reactive protein, tumor necrosis factor α, and cardiovascular risk factors before and after weight loss in obese children. Metab Clin Exp 2005; 54: 1155-1161
• 22 Rondinone CM. Adipocyte-derived hormones, cytokines, and mediators. Endocrine 2006; 29: 81-90
• 23 Shah A, Mehta N, Reilly MP. Adipose inflammation, insulin resistance, and cardiovascular disease. J Parenter Enteral Nutr 2008; 32: 638-644
• 24 Suwa T, Hogg JC, English D, Van-Eeden S. Interleukin-6 induces demargination of intravascular neutrophils and shortens their transit in marrow. Am J Physiol Heart Circ Physiol 2000; 279: H2954-2960
• 25 Tsai AC, Sandretto A, Chung YC. Dieting is more effective in reducing weight but exercise is more effective in reducing fat during the early phase of a weight-reducing program in healthy humans. J Nutr Biochem 2003; 14: 541-549
• 26 Verdaet D, Dendale P, De Bacquer D, Delanghe J, Block P, De Backer G. Association between leisure time physical activity and markers of chronic inflammation related to coronary heart disease. Atherosclerosis 2004; 176: 303-310
• 27 Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB. Low-grade systemic inflammation in overweight children. Pediatrics 2001; 107: e13
• 28 Wang R, Chen P, Chen W. Effect of diet and exercise-induced weight reduction on complement regulatory proteins CD55 and CD59 levels in overweight Chinese adolescents. J Exerc Sci Fit 2011; 9: 46-51
• 29 Weijs PJM. Validity of predictive equations for resting energy expenditure in US and Dutch overweight and obese class I and II adults aged 18–65 y. Am J Clin Nutr 2008; 88: 959-970
• 30 WHO expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet 2004; 363: 157-163
• 31 Wu Y, Huxley R, Li M, Ma J. The growing burden of overweight and obesity in contemporary China. CVD Prev Control 2009; 4: 19-26
• 32 Wu Y, Zhou B, Tao S, Wu X, Yang J, Li Y, Zhao L, Xie G. Prevalence of overweight and obesity in Chinese middle-aged populations: current status and trend of development. Chin J Epidemiol 2002; 23: 11-15
• 33 You T, Berman DM, Ryan AS, Nicklas BJ. Effects of hypocaloric diet and exercise training on inflammation and adipocyte lipolysis in obese postmenopausal women. J Clin Endocrinol Metab 2004; 89: 1739-1746
• 34 Zahorec R. Ratio of neutrophil to lymphocyte counts – rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14
• 35 Zhao Y, Wang R, Ma X, Yan X, Zhang Z, He X, He J. Distribution of C-reactive protein and its association with cardiovascular risk factors in a population-based sample of Chinese. Dis Markers 2010; 28: 333-342