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.

The authors declare no conflicts of interest.

1. Wu F, Yang Z, Ren X. Can routine hematological markers improve obesity risk stratification? A translational comment on El-Aghbary et al [Letter]. Diabetes Metab Syndr Obes. 2025;18:4097–4098. doi:10.2147/DMSO.S571753

2. El-Aghbary DA, Thabet RA, Almorish MAW, AlSayaghi KM, Elkhalifa AME. Exploring the relationship between inflammatory biomarkers and anthropometric measures of obesity in healthy adults: a case control study. Diabetes Metab Syndr Obes. 2025;18:3403–3414. doi:10.2147/DMSO.S535445

3. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: application to clinical and public health practice: a statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003;107(3):499–511. doi:10.1161/01.CIR.0000052939.59093.45

4. Tramunt B, Smati S, Grandgeorge N, et al. Sex differences in metabolic regulation and diabetes susceptibility. Diabetologia. 2020;63(3):453–461. doi:10.1007/s00125-019-05040-3

5. Kamal FD, Dagar M, Reza T, et al. Beyond diet and exercise: the impact of gut microbiota on control of obesity. Cureus. 2023;15(11):e49339. doi:10.7759/cureus.49339

6. Ramoni D, Liberale L, Carbone F, Montecucco F. Is metabolically healthy obesity shaped by inflammation, gender differences, and fat distribution? World J Cardiol. 2025;17(8). doi:10.4330/wjc.v17.i8.108749