The relationship between smoking degree based on the Brinkman index with the neutrophil lymphocyte ratio, lymphocyte platelet ratio and serum MPV/platelet values in healthy adult smokers

Smoking has been shown to increase systemic inflammation. Platelet lymphocyte ratio (PLR) and mean platelet volume (MPV) are indicators of increased platelet activation associated with venous thromboembolic events (VTE). We aim to determine the relationship between smoking degree based on the Brinkman index and the level of inflammation. An observational analytic study using a cross-sectional approach was conducted from October to December 2019 involving all adult smokers in the city of Denpasar, Bali, who meet the inclusion and exclusion criteria. Correlation test was used to determine the relationship between smoking degrees and NLR, PLR, and MPV/platelets in the subject. It was found that the research subjects had an average age of 37.13 years. Brinkman Index (IB) obtained IB 25-1000 (average 275.5506), with the ratio of mild: moderate: severe degrees are 44:45:11 people. The serum NLR value was 0.09 to 4.49 (mean 1.6633), PLR value was 47.97 to 188.81 (mean 104.4154), and MPV/Plt value 0.02 to 0.08 (mean 0.03). The degree of smoking based on the Brinkman Index in 100 samples, consisting of 44% of light smokers, 45% of moderate smokers and 11% of heavy smokers. Heavy smokers have higher NLR and PLR and lower MPV/Plt. There was no significant relationship between smoking degrees and NLR, PLR, and MPV/Plt (P = 0.494: 0.557: 0.776). All smokers classified as normal nutritional status (22%) and overweight (78%). The Spearman test showed that there was a significant relationship between smoking age and smoking degree (P = 0.000), but none for nutritional status (BMI) and smoking degree (P = 0.155). Pearson correlation test showed that the age of the smoker have no relationship with the ratio of NLR, PLR and MPV/Platelet (P = 0.670: 0.878: 0.229). T-Test result showed no relationship between NLR and PLR with nutritional status (P = 0.074: 0.116). The Mann-Whitney test also showed no relationship between MPV/Plt and nutritional status (P = 0.498). In conclusion, the higher the degree of smoking based on the Brinkman index, the higher the NLR and PLR values. There was no significant relationship between smoking degrees based on the Brinkman Index and serum NLR, PLR, and MPV/Platelet in healthy adult smokers. Keywords: Smoking degrees, Brinkman index, neutrophil lymphocyte ratio, lymphocyte platelet ratio, serum MPV/platelet.