The relationship of monocyte/HDL ratio and platelet/lymphocyte ratio with body bioimpedance measurements in obese patients

ABSTRACT Objective: Obesity has emerged as a chronic inflammatory health problem that has become increasingly prevalent in recent years. The World Health Organization (WHO) and other authorities are actively combating obesity, while researchers continue to investigate parameters that may better define its risks. Among these, the monocyte-to-HDL cholesterol ratio (MHR) and platelet-to-lymphocyte ratio (PLR) have been proposed as potential markers reflecting the inflammatory burden of obesity. In this study, we aimed to examine the relationship of these parameters with obesity, insulin resistance, and anthropometric measurements. Methods: This single-center study was conducted between February 1 and July 1, 2025, at the Obesity and Diabetes Research and Application Center outpatient clinic of Tokat Gaziosmanpaşa University. A total of 209 obese individuals were included. Patients with diabetes mellitus, hypertension, dyslipidemia, polycystic ovary syndrome (PCOS), malignancy, coronary artery disease, active infection, or those who smoked were excluded. Ethical approval was obtained from the Tokat Gaziosmanpaşa University Faculty of Medicine Non-Interventional Scientific Research Ethics Committee (approval date: 21 January 2025, decision number: 25-MOBAEK-021). Results: The study included 209 patients, with a mean age of 35.88 ± 10.21 years; 34 (16.3%) were male and 175 (83.7%) were female. We investigated the associations of MHR with sex, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and insulin resistance. Insulin resistance was present in 144 participants (68.9%), while 65 (31.1%) had no insulin resistance. WHR was elevated in 124 participants (59.3%) and normal in 85 (40.7%). According to WHtR, 137 participants (65.6%) were classified as at high metabolic risk, while 72 (34.4%) were considered low-risk. MHR showed statistically significant associations with sex, WHR, WHtR, and insulin resistance (p < 0.05). Male sex, elevated WHR, elevated WHtR, and presence of insulin resistance were all correlated with higher MHR. Across obesity subgroups, insulin resistance was found to be the most significant variable. For PLR, only sex showed a significant difference, with PLR being significantly higher in females (p = 0.022); no significant associations were found with WHtR, WHR, or insulin resistance. Conclusion: Future studies with larger sample sizes, multi-center designs, and control groups will further contribute to the literature. The significant association of MHR with insulin resistance across all obesity groups suggests that this parameter may be a valuable tool for the management of insulin resistance and the clinical follow-up of obese individuals. Keywords: Obesity, Monocyte-to-HDL Ratio (MHR), Platelet-to-Lymphocyte Ratio (PLR)