Indices of Systemic Inflammation Are Elevated in Women With Evidence of Metabolic Syndrome After Anterior Cruciate Ligament Reconstruction.

PURPOSE: To investigate the association between metabolic syndrome (MetSy) and systemic indices of the immune system and inflammation after anterior cruciate ligament reconstruction (ACLR). METHODS: This retrospective study included adult patients (≥18 years) who underwent ACLR at a single academic institution between 2009 and 2022. Patients with documented complete blood cell count ≥90 days postoperatively and complete MetSy component data were included. From complete blood cell data, the pan-immune-inflammation value (PIV), systemic inflammation response index (SIRI), systemic immune-inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio were calculated. Evidence of MetSy was defined by ≥3 of the following: body mass index ≥30, triglycerides ≥150 mg/dL, high-density lipoprotein < 40 mg/dL (men) or <50 mg/dL (women), estimated fasting glucose ≥ 100 mg/dL, and systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg. Patients (n = 130) were grouped based on MetSy status at ACLR: MetSy or non-MetSy. RESULTS: A total of 130 patients were included: 50 MetSy and 80 non-MetSy. The NLR, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, SIRI, SII, and PIV did not differ significantly between MetSy groups. However, NLR, platelet-to-lymphocyte ratio, SII, and PIV were significantly elevated (P < .01, P = .04, P < .001, and P < .01, respectively) in women compared with men with MetSy. Patients with higher body mass index and fasting glucose displayed elevated PIV (P = .01 and P = .03), whereas low high-density lipoprotein was associated with an elevation in NLR, SIRI, SII, and PIV (P = .04, P = .02, P = .04, and P = .02, respectively). The monocyte-to-lymphocyte ratio, SIRI, SII, and PIV were elevated with postoperative complications (P = .03, P < .01, P = .03, and P < .01, respectively). CONCLUSIONS: Indices of systemic inflammation after ACLR were elevated in women with evidence of MetSy. Patients with postoperative complications also exhibited an elevation in systemic indices of inflammation after ACLR. LEVEL OF EVIDENCE: Level III, retrospective comparative study.