Association between immune-inflammatory biomarkers (neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), SII, systemic inflammation response index (SIRI)) and obesity in adults: a systematic review and meta-analysis
Authors' conclusion
NLR, SII, and SIRI may serve as potential low-cost biomarkers reflecting systemic inflammation associated with obesity, while PLR appears to have limited applicability.
Study context
- Population
- Adults; studies in PubMed, EMBASE, Cochrane Library and Web of Science up to September 30, 202530 studies
- Participants
- 94,408 vs 129,927
- Comparison
- People with obesity vs people without obesity
- Obesityn = 94,408
- Controlsn = 129,927reference
- Outcome
- NLR, PLR, SII and SIRI (SMD) in people with vs without obesity
Methodological detailssubgroup and sensitivity analyses
- Subgroup and sensitivity analyses
Pooled result
As reported in the abstract
Immune-inflammatory indices (SMD)
Each group vs controlsEstimate (95% CI)P value
Obesity
SMD (NLR) 0.46(0.10–0.82)
P < 0.001Obesity
SMD (SII) 2.45(0.89–4.01)
P < 0.001Obesity
SMD (SIRI) 0.84(0.47–1.22)
P < 0.001Obesity
SMD (PLR) 0.00(−0.08-0.09)
P > 0.05Further pooled results
Subgroup analyses
- Associations more prominent in studies defining obesity by BMI, in individuals with chronic comorbidities, and in Asian and American populations
Original publication
Association between immune-inflammatory biomarkers (NLR, PLR, SII, SIRI) and obesity in adults: a systematic review and meta-analysis. Int J Obes (Lond). Published 13 June 2026. doi:10.
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