İştahsız Çocuklarda Beslenme Durumunun Değerlendirilmesinde Hematolojik-İnflamatuar İndekslerin Kullanılabilirliğinin İncelenmesi

Öz

Amaç: İştah kaybı, çocuk sağlığı pratiğinde sık karşılaşılan bir durumdur ve uzun süreli olduğunda malnütrisyon ve büyüme geriliğine yol açabilir. Nötrofil-lenfosit oranı (NLO), trombosit-lenfosit oranı (TLO), nötrofil yüzdesi/albumin oranı (NYAO), C-reaktif protein (CRP), CRP/Albümin oranı, albümin ve lenfosit değerlerinden oluşan CALLY indeksi gibi yeni inflamatuar indeksler, çeşitli erişkin hastalıklar-da araştırılmış olsa da, çocuklarda beslenme durumunun değerlendirilmesindeki rolleri net değildir. Bu çalışmada, iştahsızlık şikayeti ile başvuran çocuklarda yeni hematolojik-inflamatuar indeksler ile beslenme durumu arasındaki ilişki değerlendirilmiştir. Materyal ve Metod: Bu kesitsel çalışma Mayıs 2024 ile Şubat 2025 tarihleri arasında İstanbul’daki üçüncü basamak hastanede gerçekleştirildi. İştahsızlık şikayeti olan 2–16 yaş arası çocuklar çalışmaya dahil edildi. Bulgular: İştah kaybı olan çocuklarda, kontrol grubuna kıyasla albümin ve CALLY indeksi anlamlı de-recede daha düşüktü (p < 0.001). Ayrıca nötrofil sayısı (p < 0.001), NLO (p < 0.001), TLO (p < 0.001), NYAO (p < 0.001) ve CRP/Albümin oranı (p = 0.012) anlamlı olarak daha yüksekti. Sonuç: NYAO, CRP/Albümin oranı ve CALLY indeksi gibi yeni inflamatuar göstergeler, iştahsız çocuklarda beslenme ve inflamatuar duruma dair önemli bilgiler sunabilir. Bu indeksler, çocuk poli-kliniklerinde subklinik malnütrisyonun erken tanısında kolay erişilebilir ve maliyet etkin araçlar olabilir.

Anahtar Kelimeler

• appetite loss
• CALLY index
• children
• CRP/Albumin
• NLR
• NPAR
• PLR

Evaluating the Utility of Hematologic-Inflammatory Indices in Assessing Nutritional Status in Children with Appetite Loss

Öz

Background: Appetite loss is a common concern in pediatric practice and may lead to malnutrition and delayed growth if persistent. While novel inflammatory indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil percentage-to-albumin ratio (NPAR), CRP/Albumin, and the CRP, albu-min, and lymphocyte (CALLY) index have been investigated in various adult diseases, their role in pediatric nutritional assessment remains unclear. This study aimed to evaluate the relationship between novel hema-tologic-inflammatory indices and nutritional status in children presenting with loss of appetite. Materials and Methods: A cross-sectional study was conducted between May 2024 and February 2025 in ter-tiary hospitals in Istanbul. Pediatric patients aged 2–16 years with appetite loss were included. Results: Children with loss of appetite had significantly lower albumin and CALLY index levels (p < 0.001) com-pared to controls. Additionally, they exhibited significantly higher neutrophil counts (p < 0.001), NLR (p < 0.001), PLR (p < 0.001), NPAR (p < 0.001), and CRP/albumin ratio (p = 0.012). Conclusion: Novel inflammatory markers such as NPAR, CRP/Albumin, and the CALLY index may offer valuable insight into the nutritional and inflammatory status of children with poor appetite. These indices could serve as accessible and cost-effective tools in the early identification of subclinical malnutrition in pediatric outpati-ent settings.

Anahtar Kelimeler

• appetite loss
• CALLY index
• children
• CRP/Albumin
• NLR
• NPAR
• PLR

Kaynakça

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