Platelet to Lymphocyte Ratio and Homeostasis Model Assessment of Insulin Resistance in Pediatric Obesity and Overweight

Introduction: There is a complex interplay between obesity, inflammation and insulin resistance. We aimed to evaluate the relationship between inflammatory markers, as platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR), and insulin resistance, measured by homeostasis model assessment of insulin resistance (HOMA-IR), in a sample of overweight and obese children and adolescents. Methods: In this cross-sectional retrospective study, a total of 92 pediatric patients were enrolled (77 obese, 15 overweight) from our general pediatric outpatient clinic. All subjects had a complete blood cell count, glucose, insulin and lipid panel measurements performed in fasting blood samples. Results: HOMA-IR was positively associated with PLR (p < 0.001) and NLR (p < 0.05). After adjustment for age, sex and body mass index, the association between HOMA-IR and PLR remained statistically significant. Conclusion: The positive and independent association between PLR and HOMA-IR may stem from a pro-inflammatory status associated with obesity, and from the complex interplay between platelets, insulin signaling and inflammation. As PLR is an easily available inexpensive marker of inflammation, it is a potential biomarker of insulin resistance and severity of obesity and it could be useful in the follow-up of these patients in daily clinical practice.