Impact of Obesity on Hematological Parameters and Iron Indices

Background: Obesity in adolescents can be accompanied by dyslipidemia, insulin resistance (IR) and chronic low-grade inflammation, with increased levels of proinflammatory cytokines. Therefore, hematological parameters should be evaluated in obese children and adolescents. Objectives: Assessment of the obesity impact on hematological parameters and iron indices. Patients and methods: This cross sectional study included 60 obese children or adolescents recruited from Pediatric Obesity Clinic, Children’s Hospital, Ain Shams University, Cairo, Egypt and compared to 30 children and adolescent with normal BMI during the period from October 2023 to April 2024. Data regarding medical history, general examination, vital signs and laboratory investigation were collected. Inflammatory markers related to hematological indices were calculated and hepcidin was evaluated among cases and control using enzyme-linked immunosorbent assay (ELISA). Results: The age of cases ranged from 6 to 15 years and the mean was 10.22 ± 2.29 years with a predominance of male gender (60%). Inflammatory markers including neutrophil platelet score, immature to total neutrophil (I:T), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), neutrophil to albumin ratio, white blood cell count to mean platelet volume (WBC/MPV), systemic immune-inflammation index (SII), prognostic nutritional index (PNI) and C-reactive protein (CRP) to albumin ratio were all significantly higher among obese cases compared to the controls. Hepcidin was significantly increased among obese cases 654.6 (450.88-1608.75) pg/ml compared to the controls 102.55 (60.05-182.98) pg/ml, p-value = 0.001. Conclusion: This study illustrated the association of each of hematological indices and hepcidin with childhood obesity as hepcidin was significantly elevated among cases compared to controls, displaying a sensitivity of 98.3% and a specificity of 83.3% at a cutoff point of 302.8 pg/ml. This was linked more to inflammation and metabolic alterations as inflammatory and metabolic were also elevated among obese cases.