{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:46:46Z","timestamp":1777470406100,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,4,19]],"date-time":"2025-04-19T00:00:00Z","timestamp":1745020800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 113-2314-B-255-002"],"award-info":[{"award-number":["NSTC 113-2314-B-255-002"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Biological Research For Nursing"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Complete blood count (CBC) is a commonly used and cost-effective blood test in health screenings; however, its potential as a biomarker for early detection of chronic diseases remains underutilized. Previous studies have shown that the neutrophil-to-lymphocyte ratio (NLR) is associated with systemic inflammation and is correlated with cardiometabolic diseases (CMDs). Unhealthy lifestyles can trigger inflammatory responses and contribute to the progression of CMDs. This study aimed to explore the association between NLR levels, cardiometabolic risks, and health-related behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A community-based, cross-sectional study was conducted in collaboration with a local hospital as part of an annual health screening for rural adults. The study outcomes included CMDs, health-related behaviors, and NLR levels. A multivariable quantile regression model, adjusted for confounding factors, was used to identify factors associated with NLR levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 11,220 participants were enrolled. CMDs prevalence was 25.8%, with hypertension and diabetes being most common. Nearly half of participants reported insufficient exercise, low water intake, and inadequate oral hygiene. Higher NLR was significantly associated with CMDs (\n                      <jats:italic>p<\/jats:italic>\n                      for trend &lt;0.001). Older age (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .01) and living alone (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .01) were linked to higher NLR, while adequate water intake (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .05) and regular exercise (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; .01) were associated with lower NLR levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rural adults demonstrated a high prevalence of CMDs and inadequate health-related behaviors, which were associated with elevated NLR levels. Implementing NLR-guided lifestyle modifications and tailored health promotion programs may serve as innovative strategies to mitigate the progression of CMDs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10998004251336478","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T02:53:08Z","timestamp":1750819988000},"page":"535-543","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between the Neutrophil-To-lymphocyte Ratio and Health-related Behaviors and Factors in Rural Adults With and Without Cardiometabolic Disease"],"prefix":"10.1177","volume":"27","author":[{"given":"Hsiang-Ting","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Chih","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3621-2243","authenticated-orcid":false,"given":"Tung-Jung","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care, Chang Gung Memorial Hospital, Yunlin, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8980-1300","authenticated-orcid":false,"given":"Mei-Yen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan"},{"name":"Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan"},{"name":"School of Nursing, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,19]]},"reference":[{"key":"e_1_3_7_2_1","doi-asserted-by":"crossref","unstructured":"Angkananard T. Anothaisintawee T. McEvoy M. Attia J. Thakkinstian A. (2018). Neutrophil lymphocyte ratio and cardiovascular disease risk: A systematic review and meta-analysis. BioMed Research International 2018 Article 2703518. https:\/\/doi.org\/10.1155\/2018\/2703518","DOI":"10.1155\/2018\/2703518"},{"issue":"11","key":"e_1_3_7_3_1","first-page":"e596","article-title":"ACC\/ AHA guideline on the primary prevention of cardiovascular disease: A report of the American college of cardiology\/American heart association task force on clinical practice guidelines","volume":"140","author":"Arnett D. K.","year":"2019","unstructured":"Arnett D. K., Blumenthal R. S., Albert M. A., Buroker A. B., Goldberger Z. D., Hahn E. J., Himmelfarb C. D., Khera A., Lloyd-Jones D., McEvoy J. W., Michos E. D., Miedema M. D., Mu\u00f1oz D., Smith S. C.Jr., Virani S. S., Williams K. A.Sr., Yeboah J., Ziaeian B. (2019). 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