DOI: 10.4103/mgmj.mgmj_9_26 ISSN: 2347-7946

Association between neutrophil-to-lymphocyte ratio and obesity-related anthropometric indices: a cross-sectional study

Govind Kumar Mishra, Monal Trisal, Abhishek Sharma, Natasha Singh, Jyoti Mishra
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Abstract

Background:

Obesity is linked to chronic low-grade systemic inflammation, which plays a key role in the development of metabolic and cardiovascular diseases. The neutrophil-to-lymphocyte ratio (NLR), obtained from a routine complete blood count, has emerged as an economical and accessible marker of systemic inflammation. This study aimed to assess the relationship between NLR and obesity-related anthropometric parameters, specifically body mass index (BMI) and waist circumference (WC), in young adults.

Materials and Methods:

A cross-sectional study was conducted among 200 healthy young adults aged 18–30 years at the Department of Pathology, Kalyan Singh Government Medical College, Bulandshahr, Uttar Pradesh, India, from January to December 2024. Sample size estimation (power = 80%, α = 0.05) indicated a need for 186 participants; however, 200 individuals were included. Anthropometric measurements were obtained using standardized methods. Venous blood samples were collected in ethylenediaminetetraacetic acid Vacutainer tubes and analyzed on a Sysmex XN-1000 automated hematology analyzer. NLR was calculated from absolute neutrophil and lymphocyte counts. Data normality was assessed using the Shapiro–Wilk test. Statistical analyses included Pearson’s correlation, analysis of variance, and multivariate regression, all adjusted for age and sex.

Results:

The mean age of participants was 24.3 ± 3.2 years, with 54% males and 46% females. NLR showed a progressive increase across BMI categories (normal: 1.98 ± 0.32; overweight: 2.20 ± 0.35; obese: 2.52 ± 0.41; P < 0.001). A significant positive correlation was found between NLR and BMI ( r = 0.604, 95% confidence interval [CI]: 0.51–0.68, P < 0.0001) as well as WC ( r = 0.542, 95% CI: 0.44–0.63, P < 0.0001). Multivariate regression analysis demonstrated that both BMI ( β = 0.41, P < 0.001) and WC ( β = 0.36, P < 0.001) were independent predictors of NLR.

Conclusion:

NLR is significantly associated with adiposity markers in young adults. However, because of the study’s cross-sectional design, these findings suggest potential usefulness rather than definitive proof. Further longitudinal research is necessary before recommending NLR as a routine tool for metabolic risk.

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