Response to Letter - Can routine hematological markers improve obesity risk stratification? A translational comment on El-Aghbary et al

Sep 28, 2026

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Response to letter discussing how routine hematological markers could strengthen obesity risk stratification in clinical research. The authors acknowledge recommendations to combine CRP and ESR with metabolic indices and central adiposity measures to improve prediction of diabetes, hypertension, and cardiovascular disease. They emphasize the importance of sex-stratified analyses, broader participant age ranges, and exploring links among physical activity, constipation, gut microbiota, and inflammation. They also highlight integrated risk models to refine prediction and tailored interventions, while disclosing no conflicts of interest.

LanguageEnglish

CategoryHealthcare

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Pages2

Reading Time5 min

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Dear editor

Integration of CRP/ESR with metabolic and adiposity measures

Sex differences and participant diversity

Physical activity, constipation, and gut microbiota

Integrated risk models and clinical implications

Disclosure and publication details

Diabetes, Metabolic Syndrome and Obesity Open Access Full Text Article RESPONSE TO LETTER Can routine hematological markers improve obesity risk stratification? A translational comment on El-Aghbary et al. [Response to Letter] Dekra Ali El-Aghbary 1, Rashad Ali Thabet 2, Mohammed AWAlmorish 3, Khaled Mohammed Al-Sayaghi 4,5, Ahmed M E Elkhalifa 6 1Department of Medical Microbiology and Immunology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen; 2Department of Biochemistry, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen; 3Department of Hematology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen; 4Department of Medical Surgical Nursing, College of Nursing, Taibah University, Al-Madinah AlMunawwarah, Saudi Arabia; 5Nursing Division, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen; 6Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia Correspondence: Mohammed AW Almorish, Department of Hematology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen, [Email m.almorish@su.edu.ye](Email m.almorish@su.edu.ye); [almorish70@gmail.com](almorish70@gmail.com) Dear editor In the letter to editor titled “Can Routine Hematological Markers Improve Obesity Risk Stratification? A Translational Comment on El-Aghbary et al [Letter],” Fangying Wu et al provided insightful recommendations to enhance our future study, for which we express our gratitude and readiness to address their inquiries.1,2 Firstly, we agree with Wu et al that integrating CRP and ESR with metabolic indices and central adiposity measures enhances predictive accuracy for diabetes, hypertension, and cardiovascular disease. The combination of inflammatory markers with metrics like HOMA-IR, fasting insulin, lipid profiles, and waist circumference fosters a more holistic comprehension of individual health status.3 Secondary, your observation regarding the notable predominance of females within the obese cohort is of paramount importance. It underscores the necessity for sex-stratified analyses to ensure the applicability of our findings across diverse demographic groups. The inclusion of a broad spectrum of participants, encompassing adolescents and older adults, will undoubtedly augment the generalizability of forthcoming research endeavors.4 Thirdly, we find your insight into the correlation between reduced physical activity, constipation, and obesity to be particularly compelling. The gut–lifestyle–inflammation nexus represents a domain that warrants extensive investigation, and the incorporation of metrics pertaining to dietary fiber and microbiota could yield significant insights into modifiable lifestyle factors that influence both inflammation and adiposity.5 Fourth, the exploration of routine hematological markers in integrated risk models offers a significant opportunity to refine the prediction and management of obesity-related complications, aiming to yield nuanced insights through sex-specific and diverse healthcare assessments that could enhance tailored interventions and improve clinical practices and patient outcomes.6 Ultimately, we extend our gratitude to Fangying Wu, Zihan Yang, and Xuanxuan Ren for their insightful recommendations, which are exceedingly beneficial for the formulation of future research methodologies. Disclosure The authors declare no conflicts of interest. Received: 12 November 2025 Accepted: 19 November 2025 Published: 30 December 2025 Diabetes, Metabolic Syndrome and Obesity 2025:18 4767–4768 4767 © 2025 El-Aghbary et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at [https://www.dovepress.com/](https://www.dovepress.com/) terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v4.0) License ([http://creativecommons.org/licen

FAQs

How do the authors propose improving obesity risk stratification in future studies?

They propose integrating CRP and ESR with metabolic indices and central adiposity measures to enhance predictive accuracy for diabetes, hypertension, and cardiovascular disease.

Why do the authors stress sex-stratified analyses?

They highlight the predominance of females in the obese cohort and argue that sex-stratified analyses are needed to ensure findings apply across diverse demographic groups.

What additional lifestyle-related factors do the authors recommend investigating?

They find the connection between reduced physical activity, constipation, and obesity compelling and suggest studying dietary fiber and microbiota to better understand modifiable lifestyle influences on inflammation and adiposity.

Sep 28, 2026

Uploaded by acoobca