Evaluation of the Relationship Between Obesity and Hematological Parameters Associated with Atherosclerosis

Öz

Introduction: The aim of this study was to evaluate the relationship between obesity parameters and mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLO) and platelet-lymphocyte ratio (PLO), which are among the hemogram parameters shown to be associated with atherosclerosis. Method: The study enrolled 240 individuals admitted to the internal medicine outpatient clinic. Individuals were grouped according to their body-mass index. Obese individuals were divided into three groups as class I, class II and class III obese.
Results: 182 female and 58 male patients were included in the study. The mean age was 45.4±13.0 years and the median body-mass index was 31.4 (26.2–36.5) kg/m2. There was negative correlation between body-mass index and hemoglobin (r=-0.168, p=0.009) and hematocrit (r=-0.188, p=0.003), and a positive correlation was found between body-mass index and MPV (r=0.186, p=0.004). A negative correlation was found between weight and PLO (r=-0.143, p=0.027). There was a positive correlation between the hip circumference and MPV (r=0.155, p=0.016). There was no significant relationship between body-mass index, weight, waist circumference and, hip circumference and other hematological parameters. In the group with BMI ≥30 kg/m2, hemoglobin and hematocrit values were lower and MPV values were higher (p=0.007, p=0.002, p=0.009, respectively). MPV values were higher in class II and III obesity groups than in the class I obesity group. Conclusion: MPV and PLO values correlate with anthropometric measurements. Hemoglobin and hematocrit values decrease as the body-mass index increases.

Anahtar Kelimeler

• Atherosclerosis
• complete blood count
• obesity

Ateroskleroz ile İlişkili Hematolojik Parametrelerin Obezite ile İlişkisinin Değerlendirilmesi

Öz

Giriş: Çalışmanın amacı, obezite parametreleri ile ateroskleroz ile ilişkili olduğu gösterilen hemogram parametrelerinden ortalama trombosit hacmi (MPV), nötrofil-lenfosit oranı (NLO) ve platelet-lenfosit oranı (PLO) arasındaki ilişkinin değerlendirilmesidir. Yöntem: Çalışmaya İç Hastalıkları polikliniğine başvuran 240 birey alındı. Bireyler vücut-kitle indekslerine göre gruplandırıldı. Obez olan bireyler de kendi içinde sınıf I, sınıf II ve sınıf III obezite olarak 3 gruba ayrıldı. Bulgular: Çalışmaya 182 kadın ve 58 erkek hasta dahil edildi. Yaş ortalaması 45,4±13,0 yıl, vücut-kitle indeks ortancası 31,4 (26,2–36,5) kg/m2 idi. Vücut-kitle indeks ile hemoglobin (r=-0,168, p=0,009) ve hematokrit (r=-0,188, p=0,003) değerleri arasında negatif, vücut-kitle indeks ile MPV (r=0,186, p=0,004) arasında ise pozitif korelasyon bulundu. Kilo ile PLO arasında negatif korelasyon bulundu (r=-0,143, p=0,027). Kalça çevresi ile MPV arasında pozitif korelasyon bulundu (r=0,155, p=0,016). Vücut-kitle indeks, kilo, bel çevresi ve kalça çevresi ile diğer hematolojik parametreler arasında anlamlı bir ilişki bulunamadı. Vücut-kitle indeks ≥30 kg/m2 olan grupta, hemoglobin ve hematokrit değerleri daha düşük, MPV değerleri ise daha yüksek olarak bulundu (sırasıyla p=0,007, p=0,002, p=0,009). MPV değerleri, sınıf II ve III obezite gruplarında, sınıf I obezite grubuna göre daha yüksek bulundu. Sonuç: MPV ve PLO değerleri, antropometrik ölçümlerle korelasyon göstermektedir. Vücut-kitle indeks arttıkça hemoglobin ve hematokrit değerleri azalmaktadır.

Anahtar Kelimeler

• Ateroskleroz
• tam kan sayımı
• obezite

Kaynakça

1. 1. Global BMI Mortality Collaboration, DiAngelantonio E, Bhupathiraju ShN, Wormser D, Gao P, Kaptoge S, Berrington de Gonzalez A, et al. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet 2016 Aug 20;388(10046):776-786. doi: 10.1016/S0140-6736(16)30175-1.
2. 2. Freedman DS, Ogden CL, Goodman AB, Blanck HM. Skinfolds and coronary heart disease risk factors are more strongly associated with BMI than with the body adiposity index. Obesity (Silver Spring) 2013 Jan;21(1):E64-70. doi: 10.1002/oby.20054.
3. 3. Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, et al. The Global Syndemic of Obesity, Under nutrition, and Climate Change: The Lancet Commission report. Lancet 2019 Feb 23;393(10173):791-846. doi: 10.1016/S0140-6736(18)32822-8.
4. 4. Janssen I, Katzmarzyk PT, Ross R. Body mass index, waist circumference, and health risk: evidence in support of current National Institutes of Health guidelines. Arch Intern Med 2002 Oct 14;162(18):2074-2079.
5. 5. Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S, et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care 2002 Sep;25(9):1551-1556.
6. 6. Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N, et al.; TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013 Feb;28(2):169-180. doi: 10.1007/s10654-013-9771-5.
7. 7. Wilson PW, D'Agostino RB, Sullivan L, Parise H, Kannel WB. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med 2002 Sep 9;162(16):1867-1872.
8. 8. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996 Mar;7(2):157-161.

9. 9. van der Loo B, Martin JF. Megakaryocytes and platelets in vascular disease. Baillieres Clin Haematol 1997 Feb;10(1):109-123.
10. 10. Tavil Y, Sen N, Yazici H, Turfan M, Hizal F, Cengel A, et al. Coronary heart disease is associated with mean platelet volume in type 2 diabetic patients. Platelets 2010;21(5):368-372. doi: 10.3109/09537101003628421.
11. 11. Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost 2010 Jan;8(1):148-156. doi: 10.1111/j.1538-7836.2009.03584.x.
12. 12. Uyarel H, Ergelen M, Cicek G, Kaya MG, Ayhan E, Turkkan C, et al. Red cell distribution width as a novel prognostic marker in patients undergoing primary angioplasty for acute myocardial infarction. Coron Artery Dis 2011 May;22(3):138-144. doi: 10.1097/MCA.0b013e328342c77b.
13. 13. Papa A, Emdin M, Passino C, Michelassi C, Battaglia D, Cocci F. Predictive value of elevated neutrophil-lymphocyte ratio on cardiac mortality in patients with stable coronary artery disease. Clin Chim Acta 2008 Sep;395(1-2):27-31. doi: 10.1016/j.cca.2008.04.019.
14. 14. Zahorec R. Neutrophil-to-lymphocyte ratio. Sixteen-year-long history since publication of our article in Bratislava Medical Journal. Bratisl Lek Listy 2017;118(6):321-323. doi: 10.4149/BLL_2017_062.
15. 15. Azab B, Shah N, Akerman M, McGinn JT Jr. Value of platelet/lymphocyte ratio as a predictor of all-cause mortality afternoon-ST-elevation myocardial infarction. J Thromb Thrombolysis 2012 Oct;34(3):326-334.
16. 16. Bahadır A, Baltacı D, Türker Y, Türker Y, Iliev D, Öztürk S, et al. Is the neutrophil-to-lymphocyte ratio indicative of inflammatory state in patients with obesity and metabolic syndrome? Anatol J Cardiol 2015 Oct;15(10):816-822. doi: 10.5152/akd.2014.5787.
17. 17. Yilmaz H, Ucan B, Sayki M, Unsal I, Sahin M, Ozbek M, Delibasi T. Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity. Diabetes Metab Syndr 2015 Oct-Dec;9(4):299-304. doi: 10.1016/j.dsx.2014.04.009.
18. 18. Zhang S, Cui YL, Diao MY, Chen DC, Lin ZF. Use of Platelet Indices for Determining Illness Severity and Predicting Prognosis in Critically Ill Patients. Chin Med J (Engl) 2015 Aug 5;128(15):2012-2018. doi: 10.4103/0366-6999.161346.
19. 19. Slavka G, Perkmann T, Haslacher H, Greisenegger S, Marsik C, Wagner OF, et al. Mean platelet volume may represent a predictive parameter for overall vascular mortality and ischemic heart disease. Arterioscler Thromb Vasc Biol 2011May;31(5):1215-1218. doi: 10.1161/ATVBAHA.110.221788.
20. 20. Rechciński T, Jasińska A, Foryś J, Krzemińska-Pakuła M, Wierzbowska-Drabik K, Plewka M, et al. Prognostic value of platelet indices after acute myocardial infarction treated with primary percutaneous coronary intervention. Cardiol J 2013;20(5):491-498. doi: 10.5603/CJ.2013.0134.
21. 21. Hajian-Tilaki K, Heidari B, Hajian-Tilaki A, Firouzjahi A, Bagherzadeh M. The discriminatory performance of body mass index, waist circumference, waist-to-hip ratio and waist-to-height ratio for detection of metabolic syndrome and their optimal cut offs among Iranian adults. J Res Health Sci 2014 Autumn;14(4):276-281.
22. 22. Karakaya S, Altay M, Kaplan Efe F, Karadağ İ, Ünsal O, Bulur O, et al. The neutrophil-lymphocyte ratio and its relationship with insulin resistance in obesity. Turk J Med Sci 2019 Feb 11;49(1):245-248. doi: 10.3906/sag-1804-68.
23. 23. Wang Q, Ma J, Jiang Z, Ming L. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute pulmonaryembolism: a systematic review and meta-analysis. Int Angiol 2018 Feb;37(1):4-11. doi: 10.23736/S0392-9590.17.03848-2.Kayıkçıoğlu M, Tokgözoğlu L, Kılıçkap M, Göksülük H, Karaaslan D, Özer N, et al. [Data on prevalence of dyslipidemia and lipid values in Turkey: Systematic review and meta-analysis of epidemiological studies on cardiovascular risk factors]. Turk Kardiyol Dern Ars 2018 Oct;46(7):556-574. doi: 10.5543/tkda.2018.23450.
24. 24. Furuncuoğlu Y, Tulgar S, Dogan AN, Cakar S, Tulgar YK, Cakiroglu B. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immune-inflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci 2016 Apr;20(7):1300-1306.