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Obez ve obez olmayan çocuklarda inflamatuar hematolojik parametrelerin karşılaştırılması

Year 2023, Volume: 8 Issue: 1, 24 - 29, 07.02.2023

Fatma Demir Yenigurbuz , Elif Söbü , Berkin Berk Akbeyaz

https://doi.org/10.22391/fppc.1197997

Abstract

Giriş: Obezite, tüm dünyada giderek artan bir sağlık sorunudur ve insülin direnci (İD), hipertansiyon, ateroskleroz ve bazı kanserlerle ilgili önemli bir inflamatuar faktöre sahiptir. Bu çalışma, çocukluk çağı obezitesindeki inflamatuar hematolojik parametreleri değerlendirmeyi amaçlamaktadır.

Yöntem: Altmış dört obez ve 50 normal kilolu olgu çalışmaya dahil edildi. Hastaların fizik muayene özellikleri ve laboratuvar verileri dosyalarından geriye dönük olarak değerlendirildi. Gruplar arasında laboratuvar testleri, hematolojik parametreler, cinsiyet dağılımı karşılaştırıldı. Obez grupta insülin direnci (HOMA-IR) için Homeostasis modeli değerlendirmesi ile diğer laboratuvar parametreleri arasındaki korelasyonlar incelendi.

Bulgular: Obez grubun lökosit, nötrofil, monosit, lenfosit, trombosit ve MPV değerleri kontrol grubuna göre istatistiksel olarak yüksek bulundu (p: 0,006, p:0,015, p:0,014, p:0,001, p<0,001). Nötrofil/Lenfosit oranı (N/L), Monosit/Lenfosit oranı (M/L) ve Trombosit/Lenfosit oranı (T/L) açısından iki grup arasında istatistiksel olarak anlamlı fark yoktu (p: 0,642, p:0,989, 0,982). Ayrıca Homa IR ve yaş, VKİ, Nötrofil, Lenfosit, Monosit, Trombosit, Nötrofil/Lenfosit, Monosit/Lenfosit ve Trombosit/Lenfosit değerleri arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır.

Sonuç: Çalışmamızda obez adolesan grubunun N/L, P/L, M/L değerleri kontrol grubu ile benzerdi. Bununla birlikte, obez grubundaki lökosit, nötrofil, monosit, lenfosit, trombosit ve MPV değerleri, istatistiksel olarak kontrol grubundan daha yüksekti. Ancak bu bulgular, HOMA-IR'den bağımsız olarak obezite ve inflamasyon arasında bir ilişkiye işaret etmektedir.

Anahtar kelimeler: obezite, çocuk, inflamasyon, hematolojik parametreler

Keywords

obezite çocuk inflamasyon hematolojik parametreler

References

  • 1. Finucane MM, Stevens GA, Cowan MJ, et al. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index). National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. 2011;377(9765):557-67. https://doi.org/10.1016/s0140-6736(10)62037-5
  • 2. Kumar S, Kelly AS. Review of childhood obesity: From epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc. 2017;92(2):251-65. https://doi.org/10.1016/j.mayocp.2016.09.017
  • 3. Thomas-Eapen N. Childhood obesity. Prim Care. 2021;48(3):505-15. https://doi.org/10.1016/j.pop.2021.04.002
  • 4. Cunningham SA, Kramer MR, Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med. 2014;370(5):403-11. https://doi.org/10.1056/nejmoa1309753
  • 5. Ellulu MS, Patimah I, Khaza'ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci. 2017;13(4): 851–3. https://doi.org/10.5114%2Faoms.2016.58928
  • 6. Khanna D, Khanna S, Khanna P, Kahar P, Patel BM. Obesity: A chronic low-grade inflammation and its markers. Cureus. 2022;14(2): e22711. https://doi.org/10.7759%2Fcureus.22711
  • 7. de Heredia FP, Gómez-Martínez S, Marcos A: Obesity, inflammation and the immune system. Proc Nutr Soc 2012;71(2):332-8. https://doi.org/10.1017/s0029665112000092
  • 8. Gijsberts CM, Ellenbroek GHJM, Ten Berg MJ, Pasterkamp G, Hoefer IE, de Klejin DP, et al. Effect of monocyte-to-lymphocyte ratio on heart failure characteristics and hospitalizations in a coronary angiography cohort. Am J Cardiol. 2017;120(6):911-6.https://doi.org/10.1016/j.amjcard.2017.06.020
  • 9. Hyun S, Kwon S, Cho S, Park S, Jung W, Moon S, et al. Can the Neutrophil-to-Lymphocyte Ratio Appropriately Predict Carotid Artery Stenosis in Patients with Ischemic Stroke?-A Retrospective Study. J Stroke Cerebrovasc Dis. 2015;24(11):2646-51. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.07.024
  • 10. Obesity and overweight. World Health Organisation. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (Access Date: January 25, 2023)
  • 11. Kurtogu S, Hatipoglu N, Mazicioglu M, Kendirici M, Keskin M, Kondolot M. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods. J Clin Res Pediatr Endocrinol. 2010;2(3):100-6. https://doi.org/10.4274/jcrpe.v2i3.100
  • 12. Apperley LJ, Blackburn J, Erlandson-Parry K, Gait L, Laing P, Senniappan S. Childhood obesity: A review of current and future management options. Clin Endocrinol (Oxf). 2022;96(3):288-301. https://doi.org/10.1111/cen.14625
  • 13. Musaad S, Haynes EN. Biomarkers of obesity and subsequent cardiovascular events. Epidemiol Rev 2007:98–4. https://doi.org/10.1093/epirev/mxm005
  • 14. Fest J, Ruiter R, Ikram MA, Voortman T, van Eijck CHJ, Stricker BH. Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study. Sci Rep. 2018;8(1):10566. https://doi.org/10.1038/s41598-018-28646-w
  • 15. Zatterale F, Longo M, Naderi J, Raciti GA, Desiderio A, Miele C, et al. Chronic Adipose Tissue Inflammation Linking Obesity to Insulin Resistance and Type 2 Diabetes. Front Physiol. 2020;10:1607. https://doi.org/10.3389/fphys.2019.01607
  • 16. Pecht T, Gutman-Tirosh A, Bashan N, Rudich A. Peripheral blood leucocyte subclasses as potential biomarkers of adipose tissue inflammation and obesity subphenotypes in humans. Obes Rev. 2014;15(4):322-37. https://doi.org/10.1111/obr.12133
  • 17. Carvalheira JB, Qiu Y, Chawla A. Blood spotlight on leukocytes and obesity. Blood. 2013;122(19):3263-7. https://doi.org/10.1182/blood-2013-04-459446
  • 18. Gkrania-Klotsas E, Ye Z, Cooper AJ, Sharp SJ, Luben R, Biggs MLet al. Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies. PLoS One. 2010;5(10):e13405. https://doi.org/10.1371/journal.pone.0013405
  • 19. Lee CT, Harris SB, Retnakaran R, Gerstein HC, Perkins BA, Zinman B, et al. White blood cell subtypes, insulin resistance and β-cell dysfunction in high-risk individuals--the PROMISE cohort. Clin Endocrinol (Oxf). 2014;81(4):536-41. https://doi.org/10.1111/cen.12390
  • 20. Yoshimura A, Ohnishi S, Orito C, Kawahara Y, Takasaki H, Takeda H, et al. Association of peripheral total and differential leukocyte counts with obesity-related complications in young adults. Obes Facts. 2015;8(1):1-16. https://doi.org/10.1159/000373881
  • 21. Suwa T, Hogg JC, English D, Van Eeden SF. Interleukin-6 induces demargination of intravascular neutrophils and shortens their transit in marrow. Am J Physiol Heart Circ Physiol. 2000;279(6):H2954-60. https://doi.org/10.1152/ajpheart.2000.279.6.h2954
  • 22. Aydin M, Nalbantoglu B, Donma MM, Feti T, Volkan K, Erkut K, et al. The effect of obesity and dietary habits on mean platelet volume and other platelet indices. J Pediatr Biochem. 2014;4(3)167-70. https://doi.org/10.3233/JPB-140122
  • 23. Bordeaux BC, Qayyum R, Yanek LR, Vaidya D, Becker LC, Faraday N, Becker DM. Effect of obesity on platelet reactivity and response to low-dose aspirin. Prev Cardiol. 2010;13(2):56-62. https://doi.org/10.1111/j.1751-7141.2009.00058.x
  • 24. Aydin M, Yilmaz A, Donma MM, Tulubas F, Demirkol M, Erdogan M, Gurel A. Neutrophil/lymphocyte ratio in obese adolescents. North Clin Istanb. 2015;2(2):87-91. https://doi.org/10.14744/nci.2015.25238
  • 25. Santos C, Picoito J, Teixeira AL, Rodrigues C, Ferreira S. Platelet to lymphocyte ratio and homeostasis model assessment of insulin resistance in pediatric obesity and overweight. Rev Port Endocrinol Diabetes Metab. 2017;12(2):177-182. http://dx.doi.org/10.1016/j.rpedm.2016.10.041
  • 26. Dilek TD, Gayret OB, Kilinc S, Erol M, Yigit O, Mete F. The assessment of the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in dyslipidemic obese children. Bagcilar Med Bull 2019;4(3):56-60. https://doi.org/10.4274/BMB.galenos.2019.06.010
  • 27. Bahadir A, Baltaci D, Turker Y, Sariguzel YC, Turker Y, Lliev D, et al. Is the neutrophil-to-lymphocyte ratio indicative of inflammatory state in patients with obesity and metabolic syndrome? Anatol J Cardiol. 2015;15(10):816-22. https://doi.org/10.5152/akd.2014.5787
  • 28. Ji H, Li Y, Fan Z, Zuo B, Jian X, Li L, Liu T. Monocyte/lymphocyte ratio predicts the severity of coronary artery disease: a syntax score assessment. BMC Cardiovasc Disord. 2017;17(1):90. https://doi.org/10.1186/s12872-017-0507-4
  • 29. Xiang F, Chen R, Cao X, Shen B, Liu Z, Tan X, et al. Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all-cause mortality in hemodialysis patients: A prospective cohort study. Hemodial Int. 2018;22(1):82-92. https://doi.org/10.1111/hdi.12549
  • 30. Anik A, Celik E, Anik A. The relation of complete blood count parameters with metabolic and clinical parameters in overweight and obese children. J Pediatr Res 2021;8(2):161-70. http://doi.org/10.4274/jpr.galenos.2020.74824
  • 31. Yazaki LG, Faria JCP, Souza FIS, Sarni ROS. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios of overweight children and adolescents. Rev Assoc Med Bras 2022;68(8):1006-1010. https://doi.org/10.1590/1806-9282.20211253

The comparison of inflammatory hematological parameters in obese and non-obese children

Year 2023, Volume: 8 Issue: 1, 24 - 29, 07.02.2023

Fatma Demir Yenigurbuz , Elif Söbü , Berkin Berk Akbeyaz

https://doi.org/10.22391/fppc.1197997

Abstract

Introduction: Obesity is an increasing health problem in the whole world, and it has an important inflammatory component related to the insulin resistance (IR), hypertension, atherosclerosis and some cancers. This study aims to evaluate the inflammatory hematological parameters in childhood obesity.

Methods: Sixty-four obese and 50 normal weight cases were included in the study. The physical examination features and laboratory data of the patients were evaluated retrospectively from the patient’s files. Laboratory tests, hematological parameters, gender were compared between the groups. Correlations between Homeostasis model evaluation for insulin resistance (HOMA-IR) and other laboratory parameters in the obese group were examined.

Results: The leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values of the obese group were found to be statistically higher than the control group (p: 0.006, p:0.015, p:0.014, p:0.001, p<0.001). There was no statistically significant difference between the two groups for Neutrophile/Lymphocyte ratio (NLR), Monocyte/Lymphocyte ratio (MLR) and Platelet/Lymphocyte ratio (PLR) (p:0.642, p:0.989, 0.982). Also, there was no statistically significant correlation between Homa IR and age, BMI, Neutrophil, Lymphocyte, Monocyte, Thrombocyte, Neutrophil/Lymphocyte, Monocyte/Lymphocyte and Thrombocyte/Lymphocyte values.

Conclusion: The current study showed that there was no significant difference between obese and controls in terms of NLR, PLR, and MLR values. However, the leukocyte, neutrophile, monocyte, lymphocyte, thrombocyte and MPV values were statistically higher in obese group than controls. Nevertheless, these findings can point relation between obesity and inflammation.

Keywords: obesity, children, inflammation, hematological parameters

Keywords

obesity children inflammation hematological parameters

References

  • 1. Finucane MM, Stevens GA, Cowan MJ, et al. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Body Mass Index). National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participants. Lancet. 2011;377(9765):557-67. https://doi.org/10.1016/s0140-6736(10)62037-5
  • 2. Kumar S, Kelly AS. Review of childhood obesity: From epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc. 2017;92(2):251-65. https://doi.org/10.1016/j.mayocp.2016.09.017
  • 3. Thomas-Eapen N. Childhood obesity. Prim Care. 2021;48(3):505-15. https://doi.org/10.1016/j.pop.2021.04.002
  • 4. Cunningham SA, Kramer MR, Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med. 2014;370(5):403-11. https://doi.org/10.1056/nejmoa1309753
  • 5. Ellulu MS, Patimah I, Khaza'ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci. 2017;13(4): 851–3. https://doi.org/10.5114%2Faoms.2016.58928
  • 6. Khanna D, Khanna S, Khanna P, Kahar P, Patel BM. Obesity: A chronic low-grade inflammation and its markers. Cureus. 2022;14(2): e22711. https://doi.org/10.7759%2Fcureus.22711
  • 7. de Heredia FP, Gómez-Martínez S, Marcos A: Obesity, inflammation and the immune system. Proc Nutr Soc 2012;71(2):332-8. https://doi.org/10.1017/s0029665112000092
  • 8. Gijsberts CM, Ellenbroek GHJM, Ten Berg MJ, Pasterkamp G, Hoefer IE, de Klejin DP, et al. Effect of monocyte-to-lymphocyte ratio on heart failure characteristics and hospitalizations in a coronary angiography cohort. Am J Cardiol. 2017;120(6):911-6.https://doi.org/10.1016/j.amjcard.2017.06.020
  • 9. Hyun S, Kwon S, Cho S, Park S, Jung W, Moon S, et al. Can the Neutrophil-to-Lymphocyte Ratio Appropriately Predict Carotid Artery Stenosis in Patients with Ischemic Stroke?-A Retrospective Study. J Stroke Cerebrovasc Dis. 2015;24(11):2646-51. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.07.024
  • 10. Obesity and overweight. World Health Organisation. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (Access Date: January 25, 2023)
  • 11. Kurtogu S, Hatipoglu N, Mazicioglu M, Kendirici M, Keskin M, Kondolot M. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods. J Clin Res Pediatr Endocrinol. 2010;2(3):100-6. https://doi.org/10.4274/jcrpe.v2i3.100
  • 12. Apperley LJ, Blackburn J, Erlandson-Parry K, Gait L, Laing P, Senniappan S. Childhood obesity: A review of current and future management options. Clin Endocrinol (Oxf). 2022;96(3):288-301. https://doi.org/10.1111/cen.14625
  • 13. Musaad S, Haynes EN. Biomarkers of obesity and subsequent cardiovascular events. Epidemiol Rev 2007:98–4. https://doi.org/10.1093/epirev/mxm005
  • 14. Fest J, Ruiter R, Ikram MA, Voortman T, van Eijck CHJ, Stricker BH. Reference values for white blood-cell-based inflammatory markers in the Rotterdam Study: a population-based prospective cohort study. Sci Rep. 2018;8(1):10566. https://doi.org/10.1038/s41598-018-28646-w
  • 15. Zatterale F, Longo M, Naderi J, Raciti GA, Desiderio A, Miele C, et al. Chronic Adipose Tissue Inflammation Linking Obesity to Insulin Resistance and Type 2 Diabetes. Front Physiol. 2020;10:1607. https://doi.org/10.3389/fphys.2019.01607
  • 16. Pecht T, Gutman-Tirosh A, Bashan N, Rudich A. Peripheral blood leucocyte subclasses as potential biomarkers of adipose tissue inflammation and obesity subphenotypes in humans. Obes Rev. 2014;15(4):322-37. https://doi.org/10.1111/obr.12133
  • 17. Carvalheira JB, Qiu Y, Chawla A. Blood spotlight on leukocytes and obesity. Blood. 2013;122(19):3263-7. https://doi.org/10.1182/blood-2013-04-459446
  • 18. Gkrania-Klotsas E, Ye Z, Cooper AJ, Sharp SJ, Luben R, Biggs MLet al. Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies. PLoS One. 2010;5(10):e13405. https://doi.org/10.1371/journal.pone.0013405
  • 19. Lee CT, Harris SB, Retnakaran R, Gerstein HC, Perkins BA, Zinman B, et al. White blood cell subtypes, insulin resistance and β-cell dysfunction in high-risk individuals--the PROMISE cohort. Clin Endocrinol (Oxf). 2014;81(4):536-41. https://doi.org/10.1111/cen.12390
  • 20. Yoshimura A, Ohnishi S, Orito C, Kawahara Y, Takasaki H, Takeda H, et al. Association of peripheral total and differential leukocyte counts with obesity-related complications in young adults. Obes Facts. 2015;8(1):1-16. https://doi.org/10.1159/000373881
  • 21. Suwa T, Hogg JC, English D, Van Eeden SF. Interleukin-6 induces demargination of intravascular neutrophils and shortens their transit in marrow. Am J Physiol Heart Circ Physiol. 2000;279(6):H2954-60. https://doi.org/10.1152/ajpheart.2000.279.6.h2954
  • 22. Aydin M, Nalbantoglu B, Donma MM, Feti T, Volkan K, Erkut K, et al. The effect of obesity and dietary habits on mean platelet volume and other platelet indices. J Pediatr Biochem. 2014;4(3)167-70. https://doi.org/10.3233/JPB-140122
  • 23. Bordeaux BC, Qayyum R, Yanek LR, Vaidya D, Becker LC, Faraday N, Becker DM. Effect of obesity on platelet reactivity and response to low-dose aspirin. Prev Cardiol. 2010;13(2):56-62. https://doi.org/10.1111/j.1751-7141.2009.00058.x
  • 24. Aydin M, Yilmaz A, Donma MM, Tulubas F, Demirkol M, Erdogan M, Gurel A. Neutrophil/lymphocyte ratio in obese adolescents. North Clin Istanb. 2015;2(2):87-91. https://doi.org/10.14744/nci.2015.25238
  • 25. Santos C, Picoito J, Teixeira AL, Rodrigues C, Ferreira S. Platelet to lymphocyte ratio and homeostasis model assessment of insulin resistance in pediatric obesity and overweight. Rev Port Endocrinol Diabetes Metab. 2017;12(2):177-182. http://dx.doi.org/10.1016/j.rpedm.2016.10.041
  • 26. Dilek TD, Gayret OB, Kilinc S, Erol M, Yigit O, Mete F. The assessment of the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in dyslipidemic obese children. Bagcilar Med Bull 2019;4(3):56-60. https://doi.org/10.4274/BMB.galenos.2019.06.010
  • 27. Bahadir A, Baltaci D, Turker Y, Sariguzel YC, Turker Y, Lliev D, et al. Is the neutrophil-to-lymphocyte ratio indicative of inflammatory state in patients with obesity and metabolic syndrome? Anatol J Cardiol. 2015;15(10):816-22. https://doi.org/10.5152/akd.2014.5787
  • 28. Ji H, Li Y, Fan Z, Zuo B, Jian X, Li L, Liu T. Monocyte/lymphocyte ratio predicts the severity of coronary artery disease: a syntax score assessment. BMC Cardiovasc Disord. 2017;17(1):90. https://doi.org/10.1186/s12872-017-0507-4
  • 29. Xiang F, Chen R, Cao X, Shen B, Liu Z, Tan X, et al. Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all-cause mortality in hemodialysis patients: A prospective cohort study. Hemodial Int. 2018;22(1):82-92. https://doi.org/10.1111/hdi.12549
  • 30. Anik A, Celik E, Anik A. The relation of complete blood count parameters with metabolic and clinical parameters in overweight and obese children. J Pediatr Res 2021;8(2):161-70. http://doi.org/10.4274/jpr.galenos.2020.74824
  • 31. Yazaki LG, Faria JCP, Souza FIS, Sarni ROS. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios of overweight children and adolescents. Rev Assoc Med Bras 2022;68(8):1006-1010. https://doi.org/10.1590/1806-9282.20211253
There are 31 citations in total.

Details

Primary Language English
Subjects Paediatrics
Journal Section Original Research
Authors

Fatma Demir Yenigurbuz 0000-0001-8692-2767

Elif Söbü 0000-0002-2037-7046

Berkin Berk Akbeyaz 0000-0002-7918-7407

Publication Date February 7, 2023
Submission Date November 1, 2022
Acceptance Date January 6, 2023
Published in Issue Year 2023Volume: 8 Issue: 1

Cite

APA Demir Yenigurbuz, F., Söbü, E., & Berk Akbeyaz, B. (2023). The comparison of inflammatory hematological parameters in obese and non-obese children. Family Practice and Palliative Care, 8(1), 24-29. https://doi.org/10.22391/fppc.1197997
AMA Demir Yenigurbuz F, Söbü E, Berk Akbeyaz B. The comparison of inflammatory hematological parameters in obese and non-obese children. Fam Pract Palliat Care. February 2023;8(1):24-29. doi:10.22391/fppc.1197997
Chicago Demir Yenigurbuz, Fatma, Elif Söbü, and Berkin Berk Akbeyaz. “The Comparison of Inflammatory Hematological Parameters in Obese and Non-Obese Children”. Family Practice and Palliative Care 8, no. 1 (February 2023): 24-29. https://doi.org/10.22391/fppc.1197997.
EndNote Demir Yenigurbuz F, Söbü E, Berk Akbeyaz B (February 1, 2023) The comparison of inflammatory hematological parameters in obese and non-obese children. Family Practice and Palliative Care 8 1 24–29.
IEEE F. Demir Yenigurbuz, E. Söbü, and B. Berk Akbeyaz, “The comparison of inflammatory hematological parameters in obese and non-obese children”, Fam Pract Palliat Care, vol. 8, no. 1, pp. 24–29, 2023, doi: 10.22391/fppc.1197997.
ISNAD Demir Yenigurbuz, Fatma et al. “The Comparison of Inflammatory Hematological Parameters in Obese and Non-Obese Children”. Family Practice and Palliative Care 8/1 (February 2023), 24-29. https://doi.org/10.22391/fppc.1197997.
JAMA Demir Yenigurbuz F, Söbü E, Berk Akbeyaz B. The comparison of inflammatory hematological parameters in obese and non-obese children. Fam Pract Palliat Care. 2023;8:24–29.
MLA Demir Yenigurbuz, Fatma et al. “The Comparison of Inflammatory Hematological Parameters in Obese and Non-Obese Children”. Family Practice and Palliative Care, vol. 8, no. 1, 2023, pp. 24-29, doi:10.22391/fppc.1197997.
Vancouver Demir Yenigurbuz F, Söbü E, Berk Akbeyaz B. The comparison of inflammatory hematological parameters in obese and non-obese children. Fam Pract Palliat Care. 2023;8(1):24-9.
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