Radkhah Hanieh, Zooravar Diar, Shateri-Amiri Bahareh, Saffar Homina, Najjari Khosrow, Hazaveh Mojgan Mirabdolhagh
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of.
Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of.
Obes Surg. 2025 Feb;35(2):544-555. doi: 10.1007/s11695-024-07643-1. Epub 2025 Jan 8.
BACKGROUND/OBJECTIVE: Obesity is linked to increased risks of cardiovascular disease, diabetes, and certain cancers. Bariatric surgery (BS) aids in weight management, significantly altering body composition. This study evaluates the predictive value of five complete blood count (CBC)-derived indices [C-reactive-protein-albumin-lymphocyte (CALLY), glucose-to-lymphocyte ratio (GLR), prognostic nutritional index (PNI), hemoglobin, albumin, lymphocyte, platelet (HALP), and controlling nutritional status (COUNT)] on body composition changes post-BS.
A retrospective study was conducted on 240 patients undergoing BS at Sina Hospital, Tehran, Iran. Indices were calculated using routine laboratory tests, and body composition changes were measured using bioelectrical impedance analysis at 3 and 6 months post-surgery. RESULTS: Higher pre-surgical GLR values positively correlated with increased fat-free mass (FFM) (p = 0.005 , p = 0.003 ), muscle mass (MM) (p = 0.011 , p = 0.008 ), and total body water (TBW) (p = 0.005 , p = 0.005 ) post-surgery. In contrast, higher PNI was negatively associated with changes in FM (p = 0.029 , p = 0.015 ), FFM (p = 0.002 , p = 0.018 ), TBW (p = 0.002 , p = 0.015 ) and MM (p = 0.003 ), particularly after laparoscopic sleeve gastrectomy (LSG). Furthermore, there was a significant correlation between pre-surgical HALP score and changes in FFM (p = 0.002 , p = 0.042 ), TBW (p = 0.002 ) and MM (p = 0.011 , p = 0.041 ). In addition, the modified HALP score showed a more significant correlation compared to the HALP score to predict the changes FM (p = 0.002 , p = 0.002 ), FFM (p = 0.001 , p = 0.006 ), TBW (p = 0.001 , p = 0.003 ) and MM (p = 0.001 , p = 0.023 ) particularly, after 6 months.
Our findings suggest that pre-surgical assessment of GLR, PNI, and HALP indices may provide valuable insights into predicting changes in body composition after bariatric surgery. Specifically, these indices could serve as tools for tailoring preoperative nutritional strategies and post-surgical interventions. However, as this study is retrospective, further prospective research with longer follow-ups is required to validate these findings and evaluate their utility in clinical practice. 3 months after metabolic bariatric surgery. 6 months after metabolic bariatric surgery.
背景/目的：肥胖与心血管疾病、糖尿病及某些癌症风险增加相关。减肥手术有助于体重管理，显著改变身体成分。本研究评估了五个全血细胞计数（CBC）衍生指标[C反应蛋白-白蛋白-淋巴细胞（CALLY）、血糖与淋巴细胞比值（GLR）、预后营养指数（PNI）、血红蛋白、白蛋白、淋巴细胞、血小板（HALP）及控制营养状况（COUNT）]对减肥手术后身体成分变化的预测价值。
对伊朗德黑兰新浪医院240例行减肥手术的患者进行回顾性研究。指标通过常规实验室检查计算得出，身体成分变化于术后3个月和6个月采用生物电阻抗分析进行测量。
术前较高的GLR值与术后无脂肪量（FFM）增加（p = 0.005，p = 0.003）、肌肉量（MM）增加（p = 0.011，p = 0.008）及总体水（TBW）增加（p = 0.005，p = 0.005）呈正相关。相反，较高的PNI与脂肪量（FM）变化（p = 0.029，p = 0.015）、FFM变化（p = 0.002，p = 0.018）、TBW变化（p = 0.002，p = 0.015）及MM变化（p = 0.003）呈负相关，尤其是在腹腔镜袖状胃切除术（LSG）后。此外，术前HALP评分与FFM变化（p = 0.002，p = 0.042）、TBW变化（p = 0.002）及MM变化（p = 0.011，p = 0.041）之间存在显著相关性。此外，与HALP评分相比，改良HALP评分在预测FM变化（p = 0.002，p = 0.002）、FFM变化（p = 0.
