Abstract 2171: Nutritional mediators of inflammation: A cause for increased surveillance
Authors: Crook Jennifer , Lee Eunkyung , Xie Rui , Bolajoko Opeyemi , Loerzel Victoria 
Published: March 2024

Abstract
Background: Nutritional and inflammatory factors collected in routine cancer labs, neutrophil percentage to albumin ratio (NPAR), neutrophil lymphocyte ratio (NLR), monocyte lymphocyte ratio (MLR), and platelet lymphocyte ratio (PLR), have been shown feasible in identification of patients at risk of increased treatment complications, decreased cognition, anxiety and depression, and increased mortality. These have proven sensitive to multiple cancer types and stages, though little is known about causal pathways. The Vitamin/Mineral and Inflammatory Correlations To Understand Chronic Stress in the U.S. (The VICTUS Study) sought to elucidate a relationship between diet and food insecurity within these panels.
Methods: Using NHANES 2017/2018 surveys, adults &gt; 18 years without renal or hepatic disorders, pregnancy, alcohol, or supplement use were included. NPAR, NLR, MLR, and PLR were categorized as quartiles and compared to demographic, food security, plasma micronutrient statuses [vitamins A, B9, C, D, E, calcium (Ca), ferritin (Fe), phosphorus (P), potassium (K), sodium (Na)], and smoking, activity level, and sun exposure, using chi-square and ANOVA. ANOVA models compared food security and poverty to NPAR, NLR, MLR, and PLR means.
Results: From 3,317 participants, 50.2% were male, 54.3% non-Hispanic White, 33.7%, food insecure, 51.1% food stamp recipients, 27.7% smokers, with a mean age of 42.5 (SD 0.44), poverty to income ratio 2.79 (SD 0.08), CRP 3.90 (SD 0.18), NPAR 14.1 (SD 0.14), NLR 2.07 (SD 0.04), MLR 0.28 (SD 0.003), and PLR 118.7 (SD 1.61). CRP was found to be statistically significantly associated with all biomarker ratios (p &lt; 0.018). Significant micronutrient biomarker-inflammatory biomarker associations were identified in Fe [NPAR, MLR, PLR (p &lt; 0.001)], P [NPAR, NLR, MLR, PLR (p &lt; 0.033)], C [NPAR, NLR (p &lt; 0.008)], E [MLR, PLR (p &lt; 0.016)], K [NPAR, NLR, MLR, PLR (p &lt; 0.015)], Ca [NPAR, PLR (p &lt; 0.04)], A [NPAR (p &lt; 0.023)] and D [NLR (p &lt; 0.035)]. Significant micronutrient intake-inflammatory biomarker associations were detected in vitamin A [NPAR, PLR (p &lt; 0.013)], lycopene [NLR, PLR (p &lt; 0.035)], and B12 [NLR, PLR (p &lt; 0.031)]. Age [NPAR, NLR, MLR, PLR (p &lt; 0.001)], gender [NPAR, MLR, PLR (p &lt; 0.001)], ethnicity [NPAR, NLR, MLR (p &lt; 0.006)], and sedentariness [MLR, PLR (p &lt; 0.039)] were also associated with inflammatory markers. Poverty was significantly associated with NPAR, NLR, MLR, and CRP (p &lt; 0.018). Food insecurity was significantly associated with NPAR (p &lt; 0.001) and CRP (p &lt; 0.001).
Discussion: Food insecurity and poverty were significantly associated with NPAR, a ratio implicated in overall poorer cancer health outcomes. Multiple inadequate micronutrient intakes and plasma biomarkers were associated with inflammatory panels, though neither nutritional biomarker nor food insecurity statuses and their contributions to inflammatory processes are routinely surveilled within cancer disease and treatment.
Citation Format: Jennifer Crook, Eunkyung Lee, Rui Xie, Opeyemi Bolajoko, Victoria Loerzel. Nutritional mediators of inflammation: A cause for increased surveillance [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2171.