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    Efficacy of red cell distribution width and plateletcrit as predictors of subclinical inflammation in obesity
    (2019) Kuzu, Fatih; Ertugrul, Ismail
    Aim: The present study aimed to investigate the relationship of the hematological predictors of inflammation in complete blood count with body mass index (BMI) and homeostatic model assessment for insulin resistance (HOMA-IR) values.Material and Methods: The study included 354 subjects, who were admitted to the endocrinology outpatient clinic between January 2016 and March 2018. According to their BMI values, the subjects were divided into five groups as class III obesity, class II obesity, class I obesity, overweight, and normoweight. In addition, the subjects were divided into two groups as HOMA-IR 2.7 and HOMA-IR ≥2.7 to evaluate insulin resistance. Medical records of all the patients were reviewed and the data were collected retrospectively. As the predictors of subclinical inflammation, the mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) were compared among the study groups.Results:There were statistically significant differences among the BMI groups in terms of WBC, neutrophil count, lymphocyte count, RDW, platelet count, and PCT values. Hemoglobin, WBC, neutrophil count, lymphocyte count, RDW, platelet count, and PCT value were significantly higher in those having HOMA-IR value of ≥2.7. Multivariate linear regression analysis revealed significant correlations of BMI with RDW and PCT values, whereas HOMA-IR showed a correlation only with PCT value.Conclusion: RDW and PCT are simple and low-cost markers that are able to predict the development of cardiovascular complications and other comorbidities in overweight and obese subjects.
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    The impact of bariatric surgery on hematological inflammatory parameters
    (2019) Kuzu, Fatih; Ertugrul, Ismail
    Aim: The aim of this study was to evaluate hematological inflammatory parameters before and after bariatric surgery and investigate the effect of surgery on these parameters.Material and Methods: A total of 71 patients who underwent a Roux-en-Y gastric bypass (RYGBP) or a sleeve gastrectomy (SG) procedure were included in the study. The preoperative levels of the inflammatory parameters of C-reactive protein (CRP) and the white blood cell count (WBC), as well as the hematological inflammatory parameters of red blood cell distribution width (RDW), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and the neutrophil-to-lymphocyte ratio (NLR) were compared with the postoperative 6th and 12th month values.Results: Both the RYGBP and SG surgical techniques were used in this study. Significant reductions were seen in the postoperative 6th and 12th month values of CRP and WBC, which were used as an indicator of the severity of inflammation. Along with the decrease in BMI and the standard indicators of inflammation, there were also corresponding statistically significant changes in the levels of the more recently used hematological inflammatory markers of RDW, MPV, PDW, PCT, and NLR (p0.05).The statistical evaluation revealed a significant positive correlation between the serum WBC and CRP values and NLR measured at postoperative 6 th months. The postoperative 12 th month results indicated a significant positive correlation between the serum WBC and PCT values and also between the CRP and MPV values.Conclusion: Significant improvements were observed in previously elevated hematological inflammatory parameters in obese patients after bariatric surgery.