Uncoupling Systemic Inflammation from Body Mass Index: The Unseen Role of Visceral Adiposity and Metabolic Phenotypes—A Subgroup Analysis of the Nationwide OBREDI-TR Cohort
Year: 2026
Type: article
Abstract: Objectives: Although obesity is known to cause low-grade chronic inflammation, the extent to which body mass index (BMI) reflects this remains questionable. To investigate this, we classified a national obesity cohort by BMI and evaluated its association with complete blood count (CBC)-derived systemic inflammatory indices. Methods: This retrospective, multi-center study included 6499 adults from the OBREDI-TR cohort with available laboratory data. Patients were categorized by BMI into Class I (30.0–34.9 kg/m2, n = 2751), Class II (35.0–39.9 kg/m2, n = 1804), and Class III (≥40.0 kg/m2, n = 1944) obesity. We compared demographic, clinical, and laboratory parameters, especially in terms of CBC-derived inflammation parameters: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). Results: The Class III group was younger (42.73 ± 13.21 vs. 45.14 ± 14.12 in Class I) and predominantly female (p < 0.001 for both). None of the evaluated inflammatory indices showed significant differences across the groups (NLR, p = 0.435; PLR, p = 0.141; LMR, p = 0.520; SII, p = 0.326; SIRI, p = 0.459). Interestingly, hypertension was less common in the Class III obesity group (49.0% vs. 53.5% in Class I, p = 0.009). Conclusions: The failure of increasing inflammatory indices to parallel BMI, creating a “ceiling effect,” reflects the inadequacy of BMI in determining inflammatory burden. Evaluating the inflammatory burden of obesity through visceral adiposity and metabolic phenotyping (metabolically healthy (MHO) vs. metabolically unhealthy obesity (MUO) rather than BMI will provide a more accurate basis for objective clinical evaluation and personalized treatment.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm15103794
Authors: Kubilay İşsever, Alihan Oral, Ahmed Cihad Genç, Ihsan Solmaz, Nizameddin Koca, Ulas Serkan Topaloglu, Ismail Demir, Ahmet Dundar, Ali Kirik, Ozge Kama Basci, Hacer Sen, Emine Binnetoglu, Nalan Okuroglu, Ahmet Aydin, Zeynep Irmak Kaya, Hamit Yildiz, Aycan Acet, Gokhan Tazegul, Hasan Sozel, Osman Ozudogru, Selcuk Yaylacı, Ugur Bayram Korkmaz, Nur Duzen Oflas, Celalettin Küçük, Kamil Konur, Teslime Ayaz, Aysun Isiklar, Esref Arac, Hilmi Erdem Sumbul, Huseyin Ali Ozturk, Ali Burak Govez, Yusuf Usame Durmus, Atilla Onmez, Sibel Ocak Serin, Nazif Yalcin, Aysegul Ertinmaz, Alper Tuna Guven, Mehmet Kok, Yasin Sahinturk, Seyit Uyar
Institutions: Giresun University, Biruni University, Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi, Bursa City Hospital, Izmir Bozyaka Eğitim ve Araştırma Hastanesi, Balıkesir University, Fatih Sultan Mehmet Eğitim Ve Araştırma Hastanesi, Istanbul Medipol University, Eskişehir City Hospital, Sağlık Bilimleri Üniversitesi, Gaziantep University, Kutahya Saglik Bilimleri Universitesi, Marmara University, Akdeniz University, Erzincan Binali Yıldırım University, Sakarya University, Izmir Kâtip Çelebi University, Van Yüzüncü Yıl Üniversitesi, Recep Tayyip Erdoğan University, Bakırçay Üniversitesi, Acıbadem University, Dicle University, Adana Hospital, Düzce Üniversitesi, Ümraniye Eğitim ve Araştırma Hastanesi, Antalya Eğitim ve Araştırma Hastanesi
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W7161173953