Abstract
BACKGROUND Hemogram-derived inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) have been proposed as low-cost indices of chronic inflammation in obesity. However, findings in children remain inconsistent. This study aimed to evaluate the association between body mass index (BMI) categories and hemogram-derived inflammatory indices in children aged 6 to 9 years. MATERIAL AND METHODS This retrospective study included children who underwent routine laboratory evaluation and were categorized into 3 BMI groups (<15th percentile, 15th-85th percentile, and >85th percentile). Because height and weight measurements were available for only a minority of screened children, the final sample may not fully represent the broader pediatric population. Complete blood count parameters and derived indices (NLR, PLR, SII, SIRI) were compared across BMI groups. Correlation analysis was performed between BMI and inflammatory indices. RESULTS No significant differences were observed among BMI groups for WBC, hemoglobin, platelet count, NLR, PLR, or SII (P>0.05). SIRI was significantly higher in the >85th percentile group compared to the 15th-85th percentile group (adjusted P=0.039), while other pairwise comparisons were non-significant. No correlations were found between BMI and any hemogram-derived indices. CONCLUSIONS Most hemogram-derived inflammatory markers did not vary with BMI in children aged 6 to 9 years, and BMI was not correlated with these indices. Although SIRI was modestly higher in children with BMI >85th percentile, this finding alone does not provide clear evidence of early inflammatory changes and should be interpreted cautiously. However, routine hemogram-based indices may have limited sensitivity for detecting low-grade inflammation in this age group, possibly reflecting the early and mild stage of obesity in this 6- to 9-year-old cohort.