Evaluating the Utility of Hematologic-Inflammatory Indices in Assessing Nutritional Status in Children with Appetite Loss

Background: Appetite loss is a common concern in pediatric practice and may lead to malnutrition and delayed growth if persistent. While novel inflammatory indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil percentage-to-albumin ratio (NPAR), CRP/Albumin, and the CRP, albu-min, and lymphocyte (CALLY) index have been investigated in various adult diseases, their role in pediatric nutritional assessment remains unclear. This study aimed to evaluate the relationship between novel hema-tologic-inflammatory indices and nutritional status in children presenting with loss of appetite. Materials and Methods: A cross-sectional study was conducted between May 2024 and February 2025 in ter-tiary hospitals in Istanbul. Pediatric patients aged 2–16 years with appetite loss were included. Results: Children with loss of appetite had significantly lower albumin and CALLY index levels (p < 0.001) com-pared to controls. Additionally, they exhibited significantly higher neutrophil counts (p < 0.001), NLR (p < 0.001), PLR (p < 0.001), NPAR (p < 0.001), and CRP/albumin ratio (p = 0.012). Conclusion: Novel inflammatory markers such as NPAR, CRP/Albumin, and the CALLY index may offer valuable insight into the nutritional and inflammatory status of children with poor appetite. These indices could serve as accessible and cost-effective tools in the early identification of subclinical malnutrition in pediatric outpati-ent settings.