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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Association Between Body Mass Index Categories and Hemogram-Derived Ratios and Inflammatory Indices in Children Aged
Fatih Fakirullahoğlu1,2, S Aslı Altunbaş2, Yiğit Mustafa Ertunç1,2
1Department of Pediatrics, Göztepe Medicalpark Hospital, Istanbul, Turkey.
Insights
Most hemogram-derived inflammatory indices do not significantly differ by body mass index (BMI) categories in children aged 6-9 years. The systemic inflammation response index (SIRI) was higher in children with BMI above the 85th percentile, but this finding requires cautious interpretation.
Area of Science:
- Pediatric Health
- Biomarkers
- Inflammation Research
Background:
- Chronic inflammation is linked to obesity, with hemogram-derived indices like neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) proposed as low-cost markers.
- Previous research on these indices in pediatric obesity has yielded inconsistent results.
Purpose of the Study:
- To investigate the association between body mass index (BMI) categories and hemogram-derived inflammatory indices in children aged 6 to 9 years.
- To determine if commonly used inflammatory markers correlate with BMI in this pediatric cohort.
Main Methods:
- A retrospective analysis of children aged 6-9 years with routine laboratory evaluations.
- Categorization into three BMI groups: <15th percentile, 15th-85th percentile, and >85th percentile.
- Comparison of complete blood count parameters and derived indices (NLR, PLR, SII, SIRI) across BMI groups, with correlation analysis between BMI and these indices.
Main Results:
- No significant differences were found in WBC, hemoglobin, platelet count, NLR, PLR, or SII among BMI groups.
- The systemic inflammation response index (SIRI) was significantly higher in the >85th percentile BMI group compared to the 15th-85th percentile group.
- No significant correlations were observed between BMI and any of the evaluated hemogram-derived inflammatory indices.
Conclusions:
- Hemogram-derived inflammatory markers generally do not vary with BMI in 6- to 9-year-old children.
- While SIRI showed a modest increase in the highest BMI category, it lacks clear evidence of early inflammatory changes and warrants cautious interpretation.
- Routine hemogram-based indices may have limited sensitivity for detecting low-grade inflammation in early-stage pediatric obesity.
Abstract:
BACKGROUND Hemogram-derived inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) have been proposed as low-cost indices of chronic inflammation in obesity. However, findings in children remain inconsistent. This study aimed to evaluate the association between body mass index (BMI) categories and hemogram-derived inflammatory indices in children aged 6 to 9 years. MATERIAL AND METHODS This retrospective study included children who underwent routine laboratory evaluation and were categorized into 3 BMI groups (<15th percentile, 15th-85th percentile, and >85th percentile). Because height and weight measurements were available for only a minority of screened children, the final sample may not fully represent the broader pediatric population. Complete blood count parameters and derived indices (NLR, PLR, SII, SIRI) were compared across BMI groups. Correlation analysis was performed between BMI and inflammatory indices. RESULTS No significant differences were observed among BMI groups for WBC, hemoglobin, platelet count, NLR, PLR, or SII (P>0.05). SIRI was significantly higher in the >85th percentile group compared to the 15th-85th percentile group (adjusted P=0.039), while other pairwise comparisons were non-significant. No correlations were found between BMI and any hemogram-derived indices. CONCLUSIONS Most hemogram-derived inflammatory markers did not vary with BMI in children aged 6 to 9 years, and BMI was not correlated with these indices. Although SIRI was modestly higher in children with BMI >85th percentile, this finding alone does not provide clear evidence of early inflammatory changes and should be interpreted cautiously. However, routine hemogram-based indices may have limited sensitivity for detecting low-grade inflammation in this age group, possibly reflecting the early and mild stage of obesity in this 6- to 9-year-old cohort.
