Revista ABCd (São Paulo). 30 May, 2025

IMPACT OF SLEEVE GASTRECTOMY ON THE NEUTROPHIL-TO-LYMPHOCYTE RATIO AND THE PLATELET-TO-LYMPHOCYTE RATIO AND ITS RELATIONSHIP WITH POSTOPERATIVE WEIGHT LOSS

Tiago Cavalcanti IWANAGA
Fernando SANTA-CRUZ
Álvaro Antonio Bandeira FERRAZ
Flávio KREIMER
DOI: https://doi.org/10.1590/0102-67202025000013e1882

BACKGROUND

Obesity represents a chronic pro-inflammatory status that contributes to accelerated atherosclerosis and cell aging. Besides the widely used C-reactive protein and ferritin, other inflammatory markers have gained attention, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), which are related with the degree of inflammation in various pathological conditions, including obesity and its comorbidities.

AIMS

To compare and monitor the levels of NLR and PLR before and after sleeve gastrectomy (SG).

METHODS:

Retrospective study that included a total of 622 patients with obesity who underwent SG as primer bariatric surgery in our center. Data regarding the presence of comorbidities, including type 2 diabetes (T2D), high blood pressure (HBP) and non-alcoholic fatty liver disease (NAFLD), variations in body weight and body mass index (BMI), and biochemical markers of inflammation, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and C-reactive protein (CRP) were gathered. Values of NLR and PLR were correlated with weight loss and prognosis of comorbidities within the postoperative period.

RESULTS:

The sample was predominantly female (79.3%) with average age 36.91±10.04 years, with comorbidities including HBP (25.1%), T2D (8.0%), and NAFLD (80.1%). Patients with HBP showed reduced NLR and CRP post-intervention, while those with T2D experienced decreased CRP but increased PLR. Correlation analysis found no significant correlation between BMI/weight changes and NLR but significant correlation with PLR. Post-surgery, NLR decreased for previously NAFLD patients, and PLR increased.

CONCLUSIONS:

According to the results, patients with obesity present a significant decrease in NLR and an increase in PLR after SG.


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