Original Investigation

Can Neutrophil-to-Lymphocyte Ratio Serve as an Inflammatory Marker in Obesity?


  • Hanife Usta Atmaca
  • Feray Akbaş
  • İlker Nihat Ökten
  • Eda Nuhoğlu
  • Berrin Belçik İnal

İstanbul Med J 2014;15(4):216-220


Obesity is a disease that is known to stimulate low-grade inflammation. N/L ratio has been started to be used as an indicator of systemic inflammation. This study aims to examine the relationship between obesity and N/L ratio over anthropometric measurements, obesity grade, and some biochemical parameters.


A total of 96 obese patients (mild-moderate and severe) who were being monitored in an obesity outpatient clinic, who had no concomitant disease and no history of smoking and drug use and 20 patients of normal weight with the same characteristics, as the control group, were included in the study. Anthropometric measurements were recorded, and BMI was calculated. Biochemical tests and total blood counts were performed. N/L ratio was obtained by dividing the neutrophil count by lymphocyte count. The results were evaluated using the SPSS statistical analysis program.


A significant increase was present in the neutrophil and lymphocyte counts of the morbid obese group compared to the control groups. Due to the increased neutrophil and lymphocyte counts, even though the L/N ratio increased, it was not statistically significant. The increase in total leukocyte count of morbid obese cases was statistically significant compared to mild obese cases. While N/L ratio demonstrated a strongly positive correlation with total leukocyte count and neutrophil count, it demonstrated a weakly positive correlation with waist circumference and with hip circumference.


N/L ratio increases by obesity grade and reveals that the concomitant inflammatory response increases. A high count of circulating neutrophils in obese patients might be considered an acute inflammatory response to a chronic inflammatory state. Therefore, N/L ratio might be used as an inflammatory marker in obese patients and might be helpful in the prediction of cardiovascular and metabolic risks for the patient.

Keywords: Obesity, neutrophil to lymphocyte ratio, inflammation