Systemic immune-inflammation index (SII) and neutrophil to lymphocyte ratio (NLR) are useful markers for assessing effects of anti-inflammatory diet in patients before coronary artery bypass grafting

Abstract

Background. One of the risk factors responsible for coronary artery disease (CAD) is an inadequate diet that is frequently deficient in anti-inflammatory components, such as polyphenols and omega-3 fatty acids. The neutrophil to lymphocyte ratio (NLR) and the systemic immune-inflammation index (SII) are inflammatory markers that may reflect a diet’s antiinflammatory potential. Objective. The aim of this study was to evaluate the effects that CAD patients’ nutrition patterns have on NLR and SII. Material and methods. A retrospective study assessed the dietary habits and inflammatory marker levels in patients with advanced CAD before they underwent coronary artery bypass grafting (CABG) (n=101). Patients were divided into subgroups based on their NLR and SII levels. Results. Subgroups with lower NLR and SII levels had consumed significantly more eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (p=0.02). The group with a lower ratio of omega-6 to omega-3 fatty acids (<4:1) also had lower NLR and SII levels (p=0.007 and p=0.01, respectively). Statistically significant negative correlations were found between EPA and DHA, as well as omega-3 intake, and both NLR and SII values. No statistically significant differences were found between the subgroups with lower and higher NLR and SII values for polyphenol intakes. Conclusions. Inflammatory markers such as NLR and SII may reflect an anti-inflammatory diet consumed by cardiac patients. A simultaneous assessment of dietary habits and inflammatory parameters is beneficial in the possible prevention of adverse cardiovascular incidents after CABG. There is also a need to establish reference values for SII and NLR.