{"title":"The Evaluation of Complete Blood Cell Count-Based Inflammatory Markers in Pediatric Obesity and Metabolic Syndrome","authors":"Mustafa M. Donma, Orkide Donma","volume":159,"journal":"International Journal of Medical and Health Sciences","pagesStart":89,"pagesEnd":93,"ISSN":"1307-6892","URL":"https:\/\/publications.waset.org\/pdf\/10011092","abstract":"<p>Obesity is defined as a severe chronic disease characterized by a low-grade inflammatory state. Therefore, inflammatory markers gained utmost importance during the evaluation of obesity and metabolic syndrome (MetS), a disease characterized by central obesity, elevated blood pressure, increased fasting blood glucose and elevated triglycerides or reduced high density lipoprotein cholesterol (HDL-C) values. Some inflammatory markers based upon complete blood cell count (CBC) are available. In this study, it was questioned which inflammatory marker was the best to evaluate the differences between various obesity groups. 514 pediatric individuals were recruited. 132 children with MetS, 155 morbid obese (MO), 90 obese (OB), 38 overweight (OW) and 99 children with normal BMI (N-BMI) were included into the scope of this study. Obesity groups were constituted using age- and sex-dependent body mass index (BMI) percentiles tabulated by World Health Organization. MetS components were determined to be able to specify children with MetS. CBC were determined using automated hematology analyzer. HDL-C analysis was performed. Using CBC parameters and HDL-C values, ratio markers of inflammation, which cover neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), monocyte-to-HDL-C ratio (MHR) were calculated. Statistical analyses were performed. The statistical significance degree was considered as p &lt; 0.05. There was no statistically significant difference among the groups in terms of platelet count, neutrophil count, lymphocyte count, monocyte count, and NLR. PLR differed significantly between OW and N-BMI as well as MetS. Monocyte-to HDL-C value exhibited statistical significance between MetS and N-BMI, OB, and MO groups. HDL-C value differed between MetS and N-BMI, OW, OB, MO groups. MHR was the ratio, which exhibits the best performance among the other CBC-based inflammatory markers. On the other hand, when MHR was compared to HDL-C only, it was suggested that HDL-C has given much more valuable information. Therefore, this parameter still keeps its value from the diagnostic point of view. Our results suggest that MHR can be an inflammatory marker during the evaluation of pediatric MetS, but the predictive value of this parameter was not superior to HDL-C during the evaluation of obesity.<\/p>\r\n","references":"[1]\tT. Osadnik, K. Bujak, K. Osadnik, H. Czarnecka, N. Pawlas, R. Regula, M. Fronczek, M. Lejawa, M. Gawlita, M. Gonera, M. Goral, J. K. Strzelczyk, M. Gierlotka, A. Lekston, J. Kasperczyk, L. Polonski, and M. Gasior, \u201cNovel inflammatory biomarkers may reflect subclinical inflammation in young healthy adults with obesity,\u201d Endokrynologia Polska, vol.70, no.2, 2019\r\n[2]\tJ. Y. Yu, W.-J. Choi, H.-S. Lee, and J.-W. Lee, \u201cRelationship between inflammatory markers and visceral obesity in obese and overweight Korean adults. An observational study, \u201d Medicine, vol. 98, no.9, pp. e14740, March 2019.\r\n[3]\tM. E. Afari, and T. Bhat, \u201cNeutrophil to lymphocyte ratio (NLR) and cardiovascular diseases : an update, \u201d Expert Rev. Cardiovasc. Ther., vol. 14, no.5, pp.573-577, Mar. 2016.\r\n[4]\tR. C. Bowen, N. A. B. Little, J. R. Harmer, J. Ma, L. G. Mirabelli, K. D. Roller, A. M. Breivik, E. Signor, A. B. Miller, and H. T. Khong, \u201c Neutrophil to lymphocyte ratio as prognostic indicator in gastrointestinal cancers : a systematic review and meta-analysis, \u201d Oncotarget, vol.8, no. 19, pp.32171-32189, May 2017.\r\n[5]\tH. Ozturk, B. Ozen, G. Catli, and B. Dundar, \u201c Relations of macular variability with anthropometric measurements, metabolic parameters and inflammatory markers in children and adolescents with metabolic syndrome : A cross-sectional study, \u201d Clin. Res. Pediatr. Endocrinol., Aug 2019 Epub ahead of print.\r\n[6]\tM. Ayd\u0131n, A. Y\u0131lmaz, M. M. Donma, F. Tulubas, M. Demirkol, M. Erdogan, and A. Gurel, \u201cNeutrophil\/lymphocyte ratio in obese adolescents, North. Clin. Istanb., vol. 2, no. 2, pp. 87-91, Sept. 2015. \r\n[7]\tC. O. Marginean, L. E. Melit, D. V. Ghiga, and M. O. Marginean, \u201cEarly inflammatory status related to pediatric obesity, \u201d Front Pediatr., vol.7, pp. 241, Jun 2019.\r\n[8]\tV. Pergialiotis, E. Trakakis, C. Parthenis, E. Hatziagelaki, C. Chrelias, N. Thomakos, and N. Papantoniou, \u201cCorrelation of platelet to lymphocyte and neutrophil to lymphocyte ratio with hormonal and metabolic parameters in women with PCOS, \u201d Horm. Mol. Biol. Clin. Investig., vol. 34, no.3, pp. , Apr. 2018.\r\n[9]\tE. N. Tola, \u201cThe association between in vitro fertilization outcome and the inflammatory markers of complete blood count among nonobese unexplained infertile couples,\u201d J. Obstet. Gynecol., vol. 57, no. 2, pp. 289-294, Apr. 2018.\r\n[10]\tC. Yucel, M. Z. Keskin, O. Cakmak, B. Ergani, C. Kose, O. Celik, E. Islamoglu, M. Ucar, G. Koc, and Z. Kozacioglu, \u201cPredictive value of pre-operative inflammation-based prognostic scores (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-eosinophil ratio) in testicular sperm extraction : a pilot study,\u201d Andrology, vol. 5, no.6, pp. 1100-1104, Nov. 2017.\r\n[11]\tI. Erdim, O. Erdur, F. Oghan, F. Mete, and M. Celik, \u201cBlood count values and ratios for predicting sleep apnea in obese children,\u201d Int. J. Pediatr. Otorhinolaryngol., vol. 98, pp. 85-90, Jul. 2017.\r\n[12]\tY. Cakiroglu, F. Vural, and B. Vural, \u201cThe inflammatory markers in polycystic ovary syndrome : association with obesity and IVF outcomes,\u201d J. Endocrinol. Invest., vol. 39, no. 8, pp. 899-907, Aug. 2016.\r\n[13]\tA. Zhang, L. Ning, J. Han, Y. Ma, Y. Ma, W. Cao, X. Sun and S. Li, \u201cNeutrophil-to-lymphocyte ratio as a potential biomarker of neovascular glaucoma,\u201d Ocul. Immunol. Inflamm., Oct. 2019.\r\n[14]\tK. J. Li, X. F. Xia, M. Su,H. Zhang, W. H. Chen, and C. L. Zhou, \u201cPredictive values of lymphocyte-to-monocyte ratio (LMR) and neutrophil-to- lymphocyte ratio (NLR) in patients with oesophageal cancer undergoing concurrent chemoradiotherapy,\u201d BMC Cancer, vol. 19, pp. 1004, Oct. 2019.\r\n[15]\tA. Dirican, B. B. Kucukzeybek, A. Alacac\u0131oglu, Y. Kucukzeybek, C. Erten, U. Varol, I. Somali, L. Demir, I. V. Bayoglu, Y. Yildiz, M. Akyol, B. Koyuncu, E. Coban, E. Ulger, F. C. Unay, and M. O. Tarhan, \u201cDo the derived neutrophil to lymphocyte ratio and the neutrophil to lymphocyte ratio predict prognosis in breast cancer?, \u201d Int. J. Clin. Oncol., vol. 20, no. 1, pp. 70-81, Feb. 2015.\r\n[16]\tG. Wood, T. Grenader, S. Nash, R. Adams, R. Kaplan, D. Fisher, T. Maughan, and J. Bridgewater, \u201cDerived neutrophil to lymphocyte ratio as a prognostic factor in patients with advanced colorectal cancer according to RAS and BRAF status: a post-hoc analysis of the MRC COIN study,\u201d Anticancer Drugs, vol. 28, no. 5, pp. 546-550, Jun. 2017.\r\n[17]\tE. Erdal, and M. Inan\u0131r, \u201cPlatelet-to-lymphocyte ratio (PLR) and plateletcrit (PCT) in young patients with morbid obesity,\u201d Rev. Asoc. Med. Bras., vol. 65, no.9, pp. 1182-1187, Sept. 2019.\r\n[18]\tS. Raungkaewmanee, S. Tangjitgamo, S. Manusirivithaya, S. Srijaipracharoen, and T. Thavaramara, \u201cPlatelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer,\u201d J. Gynecol. Oncol., vol. 23, no. 4, pp. 265-273, Oct.2012.\r\n[19]\tB. Azab, N. Shah, M. Akerman, and J. T. McGinn, \u201cValue of platelet\/ lymphocyte ratio as a predictor of all-cause mortality after non-ST elevation myocardial infarction,\u201d J. Thromb. Thrombolysis, vol. 34, no. 3, pp. 326-334, Oct. 2012.\r\n[20]\tY. L. Qi, Y. Zhang, L. D. Zhao, A. X. Wang, Z. B. Wang, and Q. L. Gao, \u201cPlatelet to lymphocyte ratio in peripheral blood and body mass index : novel independent prognostic factors in patients with melanoma, \u201d Zhonghua Za Zhi, vol.97, no.47, pp.3704-3710, Dec. 2017.\r\n[21]\tL. Song, J Zhu, Z. Li, T. Wei, R. Gong, and J Lei, \u201cThe prognostic value of the lymphocyte-to-monocyte ratio for high-risk papillary thyroid carcinoma,\u201d Cancer Manag. Res., vol.11, pp. 8451-8462, Sep. 2019.\r\n[22]\tA. Usta, E. Avci, C. B. Bulbul, H. Kadi, and E. Adali, \u201cThe monocyte counts to HDL cholesterol ratio in obese and lean patients with polycystic ovary syndrome,\u201d Reprod. Biol. Endocrinol., vol. 16, pp. 34, Apr. 2018.\r\n[23]\tM. Yilmaz, and H. Kayancicek, \u201cA new inflammatory marker : Elevated monocyte to HDL cholesterol ratio associated with smoking,\u201d J. Clin. Med., vol.7, no. 4, pp.76, Apr. 2018.\r\n[24]\tS. Ganjali, A. M. Gotto, M. Ruscica, S. L. Atkin, A. E. Butler, M. Banach, and A. Sahebkar, \u201cMonocyte-to-HDL cholesterol ratio as a prognostic marker in cardiovascular diseases,\u201d J. Cell Physiol., vol. 233, no.12, pp. 9237-9246, Dec. 2018.\r\n[25]\tJ. W. Chen, C. Li, Z. H. Liu, Y. Shen, F. H. Ding, X. Y. Shu, R. Y. Zhang, W. F. Shen, L. Lu, and X. Q. Wang, \u201cThe role of monocyte to high-density lipoprotein cholesterol ratio in prediction of carotid intima-media thickness in patients with type 2 diabetes,\u201d Front. Endocrinol.(Lausanne), vol. 10, pp.191, Apr. 2019.\r\n[26]\tWorld Health Organization (WHO). The WHO Child Growth Standards. Available at: http:\/\/www.who.int\/childgrowth\/en\/ Accessed on June 10, 2016.\r\n[27]\tP. Zimmet, K. G. Alberti, F. Kaufman, N. Tajima, M. Silink, S. Arslanian, G. Wong, P. Bennett, J. Shaw, S. Caprio, and IDF consensus group, \u201cThe metabolic syndrome in children and adolescents- an IDF consensus report\u201d, Pediatr. Diabetes, vol. 8, no. 5, pp. 299 - 306, Oct. 2007.","publisher":"World Academy of Science, Engineering and Technology","index":"Open Science Index 159, 2020"}