Blood count to determine chronic inflammation severity in obese adolescents
Abstract
Background Obesity is a growing public health problem of rapidly increasing prevalence in developing countries. Chronic low-grade inflammation plays a key role in the pathophysiology of obesity. Blood count values and ratios have been used as markers of inflammatory diseases. These parameters may be useful to determine the severity of chronic inflammation in obese children.
Objective To determine if red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet distribution width (PDW), and platelet-to-lymphocyte ratio (PLR) can be useful for determining the severity of chronic inflammation in obese children.
Methods This observational, analytic study was conducted in obese adolescents aged 14-18 years at senior high schools in Manado, North Sulawesi, from July to September 2018. Students with congenital anomalies, autoimmune diseases, history of asthma, or malignancy were excluded. Pearson’s correlation was used to analyze for potential relationships between obesity and red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet distribution width (PDW), and platelet-to-lymphocyte ratio (PLR).
Results There was a negative relationship between obesity and MPV, but it was not statistically significant (r=-0.006; P=0.485). There were positive, but not significant relationships between obesity and RDW (r=0.139; P=0.192), NLR (r=0.155; P=0.166), PDW (r=0.02; P=0.45), and PLR (r=0.146; P=0.181).
Conclusion The RDW, NLR, MPV, PDW, and PLR values are not significantly associated with severity of obesity in adolescents.
References
Oddo VM, Maehara M, Rah JH. Overweight in Indonesia: an observational study of trends and risk factors among adults and children. BMJ Open. 2019; 9: e031198. DOI: 10.1136/bmjopen-2019-031198.
Soriano- Guillen- L, Hernandez-Garcia B, Pita J, Dominguez-Garrido N, Del Rio-Camacho G, Rovira A. High-sensistivity C-reactive protein is a good marker of cardiovascular risk in obese children and adolescents. Euro J Endocrinology. 2008; 159:R1-R4. DOI: 10.1530/EJE-08-0212.
Kuzu F, Ertugrul I. Efficacy of red cell distribution width and plateletcrit as predictors of subclinical inflammation in obesity. Ann of Med Research. 2019;26:2266-71. DOI: 10.5455/annalsmedres.2019.10.630.
Wohlfahrt-Veje C, Tinggaard J, Winther K, Mouritsen A, Hagen CP, Mieritz MG, et al. Body fat throughout childhood in 2647 healthy Danish children: agreement of BMI, waist circumference, skinfolds with dual X-ray absorptiometry. Eur J Clin Nutr. 2014; 68: 664-70. DOI: 10.1038/ejcn.2013.282.
Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. J Family Med Prim Care. 2015;4:187-92. DOI: 10.4103/2249-4863.154628.
Kaunang ED, As’ad S, Warouw, SM, Kabo P. High sensitivity C-reactive protein, left ventricular mass, and systolic function in obese adolescents. Paediatrica Indonesiana. 2016;56:124-8. DOI: 10.14238/pi56.2.2016.124-8.
Erdim I, Erdur O, Oghan F, Mete F, Celik M. Blood count values and ratios for predicting sleep apnea in obese children. Int J Pediatr Otorhinolaryngol. 2017;98:85-90. DOI: 10.1016/j.ijporl.2017.04.043.
Hu ZD. Red blood cell distribution width: a promising index for estimating activity of autoimmune disease. J Lab Precision Med. 2016:1:1-4. DOI: 10.21037/jlpm.2016.10.02.
Lee JS, Hong SK, Kim DH, Lee JH, Lee HJ, Park B, et al. The neutrophil-to-lymphocyte ratio in children with sudden sensorineural hearing loss: a retrospective study. Acta Otolaryngol. 2017;137:35-8. DOI: 10.1080/00016489.2016.1217561.
Straub RH, Schradin C. Chronic inflammatory systemic diseases. Evol Med Public Health. 2016; 37-51. DOI: 10.1093/emph/eow001.
Fest J, Ruiter R, Ikram MA, Voortman T, van Eijck CHJ, Stricker BH. Reference values for white blood-cell-based inflammatory markers in the Rotterdam study: a population-based prospective cohort study. Sci Rep. 2018; 8: 10566. DOI: 10.1038/s41598-018-28646-w.
Donma O, Donma MM, Nalbantoglu B, Topcu B, Tulubas F, Aydin M, et al. The importance of erythrocyte parameters in obese children. Int J Med Health Sci. 2015;9:361-4. DOI: 10.5281/zenodo.1100631.
Su C, Liao LZ, Song Y, Xu ZW, Mei WY. The role of red blood cell distribution width in mortality and cardiovascular risk among patients with coronary artery diseases: a systematic review and meta-analysis. J Thorac Dis. 2014; 6: 1429-40. DOI: 10.3978/j.issn.2072-1439.2014.09.10.
Mohamed MM, Mahgoub NM, Osman NM, Saeed SS, Elmubark TY, Abass AE. Reference value of neutrophil-lymphocyte ratio in healthy Sudanese in Khartoum. Sch J App Med Sci. 2017;5;1915-9. DOI: 10.21276/sjams.
Avcil S. Evaluation of the neutrophil/ lymphocyte ratio, platelet/ lymphocyte ratio, and mean platelet volume as inflammatory markers in children with attention-deficit hyperactivity disorder. Psychiatry Clin Neurosci. 2018;72:522-30. DOI: 10.1111/pcn.12659.
Aydin M, Yilmaz A, Donma MM, Tulubas F, Demirkol M, Erdogan M, et al. Neutrophil/lymphocyte ratio in obese adolescents. North Clin Istanb. 2015;2:87-91. DOI: 10.14744/nci.2015.25238.
Aktas G, Kocak MZ, Duman TT, Erkus E, Atak BM, Sit M, et al. Mean platelet volume (MPV) as an as an inflammatory marker in type 2 diabetes meillitus and obesity. Bali Med J. 2018;7:650-3. DOI: 10.15562/bmj.v7i3.806.
Kepekci AH. MPV and PDW as inflammatory indicators in chronis otitis media with effusion. Biomed Res. 2018;29:1730-3. DOI: 10.4066/biomedicalresearch.29-17-3364.
Aydin M, Nalbantoglu B, Donma MM, Tulubas F, Kuakyalcin V, Karasu E, et al. The effect of obesity and dietary habits on mean platelet volume and other platelet indices. J Pediatr Biochem. 2014;4:167-70. DOI: 10.1055/s-0036-1586477.
Santos C, Picoito J, Teixeira AL, Rodrigues C, Ferreira S. Platelet to lymphocyte ratio and homeostasis model assessment of insulin resistance in pediatric obesity and overweight. Rev Port Endocrinol Diabetes Metab. 2017;12:177-82. DOI: 10.1016/j.rpedm.2016.10.041.
Ellulu MS, Patimah I, Khaza’ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci. 2017;13:851-63. DOI: 10.5114/aoms.2016.58928.
Copyright (c) 2020 Handoko Lowis
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2020-01-28
Published 2020-01-28
