Abstract

Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and the systemic immune inflammation index (SII) are effective prognostic markers of patients in various clinical situations such as cancer, cardiovascular diseases and inflammatory diseases. This study aims to explore the reference values based on gender and age for NLR, PLR, LMR and SII in the Moroccan population. From January 2018 to February 2020, data of ostensibly healthy adults were collected retrospectively from the laboratory information system (LIS) of the Laboratory for Research and Medical Analysis of the Fraternal Royal Gendarmerie, Rabat (Morocco). A total of 5,898 men and 10,172 women aged between 18 and 90 years were included. RIs of each parameter were established and validated in accordance with the Clinical and Laboratory Standards Institute (CLSI) document C28-A3. NLR was significantly different between men and women (p < 0.05), while PLR, LMR and SII were not. The values of NLR, PLR, LMR and SII differed significantly between different age groups of both genders (p < 0.05). Therefore, RI of PLR, LMR, and SII had to be divided into groups based on age, but not on gender, while establishing the NLR reference intervals took into account both factors; age and gender. This paper provides Reference Intervals for NLR, PLR, LMR, and SII according to age and gender in healthy Moroccan adults. This can improve assessment and potentially widen the use of these biomarkers in Moroccan clinical context.

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