Correlation between lymphocyte-monocyte ratio and hand grip strength in breast cancer patients before chemotherapy

Abstract

Background: Inflammatory cytokines have been shown to prompt muscle wasting, ultimately stimulating protein catabolism and suppressing muscle synthesis. A low lymphocyte to monocyte ratio (LMR) has been reported to be a poor prognostic indicator in several malignancies. Muscle wasting and decreased muscle mass, known as sarcopenia, manifest as low muscle strength, decreased physical performances and quality of life. However, the possible association between inflammatory parameters and sarcopenia is poorly understood especially in breast cancer patients. The objective here was to study correlation between LMR and Hand Grip Strength (HGS) in breast cancer patients before chemotherapy. Methods: Breast cancers patients before undergoing chemotherapy were consecutively included in this study. This cross-sectional study was done in a type B referral hospital in Karawaci, Tangerang, Banten, Indonesia. Patients with other chronic diseases were excluded. Hydraulic JAMAR dynamometer with Southampton protocol was used as a tool to evaluate HGS. The best score from 6 attempts, 3 of each side was noted as hand-grip strength. Venous blood was taken to evaluate white blood cell differential counts. Pearson correlation statistic was used to evaluate the correlation between them. Results: Twenty-one eligible breast cancer subjects were enrolled in this study. All subjects were female with mean age of 47.8 + 11.3 years. No subjects had body mass index (BMI) less than 18.5 kg/m2. Nine (42.9%) subjects were obese. The mean BMI was 24.8 + 3.2; mean HGS was 17.25 + 3.7; and mean LMR was 5.67 + 3.92. LMR and age were correlated with HGS with (r, 0.626; p 0.002) and (r, -0.700; p, 0.001), respectively. There is no statistically significant correlation between LMR and BMI (r, 0.042; p, 0.856). Conclusions: There is a good correlation between LMR and HGS in breast cancer patients before chemotherapy.