Background: Obesity and its related diseases, type 2 diabetes (T2D) and overall metabolic syndrome, often show a low-grade of chronic inflammation due to loss of balance between pro- and anti-inflammatory signals. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are considered cost-effective markers for the detection of this subclinical inflammation.
Objectives: To evaluate the potential prognostic factor of NLR and PLR as inflammatory biomarkers on weight loss and T2D remission after sleeve gastrectomy (SG).
Setting: University Medical Institutions.
Methods: Patients who underwent SG as primary treatment for severe obesity were included. Anthropometric and blood parameters were measured at baseline and postoperatively (1, 2, and 5 yr after surgery). The prognostic ability of NLR and PLR was evaluated by a receiver operator characteristic curve and a cutoff point was calculated. A value of P < .05 was considered significant.
Results: A total of 182 patients were analyzed. Preoperative NLR showed an inverse correlation with excess weight loss (Spearman -.525; P = .033) and units of body mass index lost (Spearman -.502; P = .039) 5 years after surgery. Preoperative NLR also showed a direct correlation with fasting glucose (Spearman .685; P = .002) and Homeostasis Model Assessment of Insulin Resistance (Spearman .764; P < .001). Lower preoperative NLR is also associated with a complete remission of T2D at 5 years. Preoperative PLR did not show any correlation with the variables studied.
Conclusion: The preoperative NLR is a potential prognostic factor of long-term weight loss and T2D remission in patients undergoing SG. PLR does not correlate with metabolic parameters in these patients.
Keywords: Inflammatory biomarkers; Metabolic syndrome; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; Sleeve gastrectomy; White blood cell count.
Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.