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Anthropometric Measurements and Inflammatory Marker in Obese Women

1Faculty of Medicine, Universitas Diponegoro, Indonesia

2Department of Clinical Pathology, Faculty of Medicine, Universitas Diponegoro, Indonesia

3Department of Public Health Science, Faculty of Medicine, Universitas Diponegoro, Indonesia

Received: 10 Feb 2021; Published: 1 Jun 2022.

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Background: Obesity is one of global epidemic health problems and its prevalence is higher among women. Obesity can cause low grade chronic inflammation mechanism in adipose tissue, which is characterized by the increase of proinflammatory cytokines and adipokines. Neutrophil lymphocyte ratio (NLR) is a simple inflammatory marker which can be reliable in evaluating the inflammatory status occurring in obese women. Waist to height ratio (WHtR) and waist to hip ratio (WHR) are anthropometric measurements, have been reported to be associated with obesity and risk of metabolic syndrome.

Objective: This study aimed to determine the correlation of WHtR and WHR with NLR in population of obese women.

Materials and Methods: This was a cross sectional study enrolling 80 obese women with Body mass index (BMI) > 27 aged 30 - 50 years in National Diponegoro Hospital Semarang, Indonesia. WHtR was determined by dividing waist circumference by height and WHR was determined by dividing waist circumference by hip circumference. NLR was examined manually from automatic hematology analyzer by dividing absolute neutrophil count (ANC) and absolute lymphocyte count (ALC). Spearman correlation test was performed, p<0.05 was considered as statistically significant.

Results: There was significant weak positive correlation between WHtR and NLR in obese women (p = 0,046; r = 0,224). There was no significant correlation between WHR and NLR in obese women (p = 0,961; r = 0,006).

Conclusion: The present study showed that WHtR is one of better anthropometric measurement because it is associate with NLR as a simple marker of inflammation in obese women.


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Keywords: WHtR; WHR; NLR; Obesity

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  1. Kementerian Kesehatan Republik Indonesia. Laporan Nasional Riskesdas 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan. 2018
  2. World Health Statistics 2016: Monitoring Health For The SDGs, Sustainable Development Goals. Available at
  3. Laporan Provinsi Jawa Tengah: RISKESDAS 2018, Lembaga Penerbit Badan Litbang Kesehatan 2019
  4. Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378(9793):815–25
  5. Patidar OP. Higher prevalence rate of CHD in ‘apple type of obesity’cases as compared to ‘pear type obesity’cases. Indian J Clin Pract. 2013;23(12):791–4
  6. Gokulakrishnan K, Ranjani H, Weber MB, Pandey GK, Anjana RM, Balasubramanyam M, et al. Effect of lifestyle improvement program on the biomarkers of adiposity, inflammation and gut hormones in overweight/obese Asian Indians with prediabetes. Acta Diabetol. 2017;54(9):843–52
  7. Anuurad E Shiwaku K, Nogi A, Kitajima K, Enkhmaa B, Shimono K, Yamane Y. The New BMI Criteria for Asians by the Regional Office for the Western Pacific Region of WHO are Suitable for Screening of Overweight to Prevent Metabolic Syndrome in Elder Japanese Workers. Journal of occupational health. 2003;45:335-43
  8. Ko K-P, Oh D-K, Min H, Kim C-S, Park J-K, Kim Y, et al. Prospective study of optimal obesity index cutoffs for predicting development of multiple metabolic risk factors: the Korean genome and epidemiology study. J Epidemiol. 2012;22(5):433–9
  9. Labarrere CA, Woods JR, Hardin JW, Campana GL, Ortiz MA, Jaeger BR, et al. Early prediction of cardiac allograft vasculopathy and heart transplant failure. Am J Transplant. 2011;11(3):528–35
  10. Phillips CM, Perry IJ. Does inflammation determine metabolic health status in obese and nonobese adults? J Clin Endocrinol Metab. 2013;98(10):E1610–9
  11. Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. JNCI J Natl Cancer Inst. 2014;106(6):8
  12. Proctor MJ, McMillan DC, Morrison DS, Fletcher CD, Horgan PG, Clarke SJ. A derived neutrophil to lymphocyte ratio predicts survival in patients with cancer. Br J Cancer. 2012;107(4):695–9
  13. Misra A, Vikram NK, Gupta R, Pandey RM, Wasir JS, Gupta VP, Waist circumference cutoff points and action levels for Asian Indians for identification of abdominal obesity, International Journal of Obesity, 2006;30:106–111
  14. Yoo E-G. Waist-to-height ratio as a screening tool for obesity and cardiometabolic risk. Korean J Pediatr. 2016;59(11):425
  15. World Health Organization (WHO). Waist Circumference and Waist Hip Ratio. Report of WHO Expert Consultation. Geneva; 2008
  16. Hastuti J, Kagawa M, Byrne NM, Hills AP. Determination of new anthropometric cut-off values for obesity screening in Indonesian adults. Asia Pac J Clin Nutr. 2017;26(4):654–5
  17. Song M, Graubard BI, Rabkin CS, Engels EA, Neutrophil-to-lymphocyte ratio and mortality in the United States general population, Natureb Research, 2021; 11:464
  18. Atmaca HU, Akbaş F, Ökten İN, Nuhoğlu E, İnal BB. Can Neutrophil-to-Lymphocyte Ratio Serve as an Inflammatory Marker in Obesity? Ren Fail. 2014;10:15
  19. Moursy EY, Megallaa MH, Mouftah RF, Ahmed SM. Relationship between neutrophil lymphocyte ratio and microvascular complications in Egyptian patients with type 2 diabetes. Am J Intern Med. 2015;3(6):250–5
  20. de Heredia FP, Gómez-Martínez S, Marcos A. Obesity, inflammation and the immune system. Proc Nutr Soc. 2012;71(2):332–8
  21. Forget P, Khalifa C, Defour J-P, Latinne D, Van Pel M-C, De Kock M. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017;10(1):12
  22. Dixon JB, O’Brien PE. Obesity and the white blood cell count: changes with sustained weight loss. Obes Surg. 2006;16(3):251–7
  23. Haffner SM. Abdominal adiposity and cardiometabolic risk: do we have all the answers? Am J Med. 2007;120(9):S10–6
  24. Nishimura S, Manabe I, Nagai R. Adipose tissue inflammation in obesity and metabolic syndrome. Discov Med. 2009;8(41):55–60
  25. Rodríguez-Rodríguez E, López-Sobaler AM, Ortega RM, Delgado-Losada ML, López-Parra AM, Aparicio A. Association between Neutrophil-to-Lymphocyte Ratio with Abdominal Obesity and Healthy Eating Index in a Representative Older Spanish Population. Nutrients. 2020;12(3):855
  26. Serbanescu C, Topor L, Gheorghe-Fronea I, Nila A, Sirbu A, Fica S. Neutrophil to lymphocyte ratio: relationship with anthropometric and metabolic parameters in morbidly obese patients. In: 17th European Congress of Endocrinology. BioScientifica; 2015
  27. Bener A, Yousafzai MT, Darwish S, Al-Hamaq AOAA, Nasralla EA, Abdul-Ghani M. Obesity index that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. J Obes. 2013;20
  28. Carranza-Lira S, Montiel MM, Camacho KO, Santana XH, Ortiz SR, Muñoz EL, et al. Relationship of the neutrophil/lymphocyte ratio with cardiovascular risk markers in premenopausal and postmenopausal women. Przegla̜d Menopauzalny,Menopause Rev. 2020;19(2):53
  29. Dev N, Marcus SR. High sensitive C-reactive protein, an independent and early novel inflammatory marker in healthy obese women. Biomed Res. 2012;23(1)
  30. Rias YA, Kurniasari MD, Traynor V, Niu SF, Wiratama BS, Chang CW, et al. Synergistic Effect of Low Neutrophil–Lymphocyte Ratio With Physical Activity on Quality of Life in Type 2 Diabetes Mellitus: A Community-Based Study. Biol Res Nurs. 2020;22(3):378–87
  31. Li J, Chen Q, Luo X, Hong J, Pan K, Lin X, et al. Neutrophil‐to‐lymphocyte ratio positively correlates to age in healthy population. J Clin Lab Anal. 2015;29(6):437–43

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