Effect of Sleeve Gastrectomy on the Neutrophil-to-Lymphocyte Ratio, the Platelet-to-Lymphocyte Ratio, Platelet Counts, and Mean Platelet Volumes


The correlation of obesity with chronic inflammation and thrombotic processes leads to morbidity and mortality. This risk is associated with platelet (PLT) hyperactivity, which increases platelet aggregation and adhesion to the vascular endothelium, thereby leading to a clotting condition. PLT activity is strongly related to the mean platelet volume (MPV). This study aims to investigate the effects of laparoscopic sleeve gastrectomy (LSG) on platelet count, MPV, the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR) in patients with morbid obesity. Our study included 252 patients who underwent LSG. The results of routine physical examination and laboratory parameters, which were performed prior to the surgery, were statistically compared with the same parameters at the end of the first year. The mean preoperative body mass index (BMI) of the patients was 46.00 ± 7.12 kg/m2, whereas the average BMI was 28.01 ± 6.43 kg/m2 in the first postoperative year. The mean platelet count decreased significantly (295.80 ± 68.51 vs. 269.70 ± 71.69 × 109/L; p < 0.001), whereas postoperative MPV increased significantly (9.19 ± 0.98 vs. 9.62 ± 1.14 fL; p < 0.001). NLR and PLR levels decreased significantly after LSG (2.49 ± 1.87 vs. 1.69 ± 0.71; p < 0.001 and 121.59 ± 46.52 vs. 105.39 ± 36.75; p = 0.001, respectively). Our results showed that platelet counts decreased significantly, as MPV levels increased significantly after LSG. In addition, NLR and PRL levels considerably decreased after LSG. There was a positive correlation between these results and changes in BMI.

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Correspondence to Muhammed Rasid Aykota.

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The study protocol was approved by the Clinical Research Ethics Committee of the Faculty of Medicine, University of Pamukkale (ethics committee approval number, 60116787-020/28616). The study was conducted in accordance with the 1964 principles of the declaration of Helsinki.

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Aykota, M.R., Yilmaz, S., Atabey, M. et al. Effect of Sleeve Gastrectomy on the Neutrophil-to-Lymphocyte Ratio, the Platelet-to-Lymphocyte Ratio, Platelet Counts, and Mean Platelet Volumes. Indian J Surg (2020). https://doi.org/10.1007/s12262-020-02497-0

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  • Obesity
  • Sleeve gastrectomy
  • Platelet
  • Mean platelet volume
  • The neutrophil-to-lymphocyte ratio
  • The platelet-to-lymphocyte ratio
  • Chronic inflammation