Bone mineral density and complete blood count ratios in children and adolescents with obesity

Abstract

Objective: Monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-high-density lipoprotein ratio (MHR), and mean platelet volume (MPV) are considered novel inflammatory markers. In this study, we aimed to investigate the relationship between bone mineral density (BMD) Z score and blood cell composition in children and adolescents with obesity and to create a suitable index for the diagnosis of obesity-associated osteoporosis.

Patients and methods: We included 148 children, comprising 112 children with obesity (obese group) and 36 sex- and age-matched healthy children (normal weight) (control group). Patient details acquired from medical records were used to measure blood count levels; BMD, using dual-energy X-ray absorptiometry; and BMD Z-scores, using race and sex specific curves.

Results: Mean BMD Z score in the obese and normal weight group was within the normal limits and significantly higher in the obese group. The BMD Z score showed a significant relationship with MLR and PLR. Patient BMD Z-scores were negatively correlated with MLR and PLR in the obese group and positively correlated in the control group. In addition, a positive correlation was found between BMD Z score and NLR in the control group.

Conclusions: Our study outcomes show that there may be a relationship between bone mass and inflammation expressed as PLR and MLR in obese children and adolescents. PLR and MLR, which are common indicators of morbidity and mortality in many chronic inflammatory diseases, may also be useful for evaluating bone status in children with obesity. However, further research on the subject is warranted.