Adipokines and C-reactive protein as indicators of MetS presence in obese Greek children: The Healthy Growth Study

C-Reactive Protein and Metabolic Syndrome in Obese and Normal Weight Hungarian Children

INTRODUCTION

It is well known that obese children frequently have high C-reactive protein (CRP) values. There are controversies about the association of the CRP and components of the metabolic syndrome (MetS). The aim of this study was to determine among children and adolescents the link between the most routinely used inflammation marker, CRP, and components of the MetS.

METHODS

The study recruited 506 obese/overweight and 249 normal weight participants (ages 4-18 years) with complete fasting laboratory and anthropometric data. Statistical analyses, including multinomial logistic regression, were conducted in R, with significance set at p < 0.05.

RESULTS

Children were divided into three groups according to CRP concentration (low <1 mg/L, medium: 1-3 mg/L, high >3 mg/L). The children were also classified whether they had MetS (n = 249) or were free of MetS (n = 421). We found highly significant difference between CRP groups in the occurrence of the MetS components (p < 0.001), hypertension (p < 0.001), hypertriglyceridemia (p < 0.001), and low high-density lipoprotein (HDL) cholesterol (p = 0.001), waist circumference (p < 0.001), body mass index (BMI) z-score (p < 0.001), fasting plasma glucose (p < 0.001), homeostasis model assessment of insulin resistance (p < 0.001), respectively. However, when BMI z-score was included in the model this relationship disappeared, suggesting that BMI has a more significant effect on the MetS components than CRP.

CONCLUSION

Our results demonstrate that BMI z-score is the main determinant of the MetS and its components. However, CRP remains an important factor to be checked in overweight and obese children.

Mechanisms and risk factors of metabolic syndrome in children and adolescents

Metabolic syndrome (MetS) is a complex disorder characterized by abdominal obesity, elevated blood pressure, hyperlipidemia, and elevated fasting blood glucose levels. The diagnostic criteria for MetS in adults are well-established, but there is currently no consensus on the definition in children and adolescents. The etiology of MetS is believed to involve a complex interplay between genetic predisposition and environmental factors. While genetic predisposition explains only a small part of MetS pathogenesis, modifiable environmental risk factors play a significant role. Factors such as maternal weight during pregnancy, children's lifestyle, sedentariness, high-fat diet, fructose and branched-chain amino acid consumption, vitamin D deficiency, and sleep disturbances contribute to the development of MetS. Early identification and treatment of MetS in children and adolescents is crucial to prevent the development of chronic diseases later in life. In this review we discuss the latest research on factors contributing to the pathogenesis of MetS in children, focusing on non-modifiable and modifiable risk factors, including genetics, dysbiosis and chronic low-grade inflammation.

Comparison between School-Age Children with and without Obesity in Nutritional and Inflammation Biomarkers

Childhood obesity is a major health problem. We examined differences between children with obesity and normal weight in nutritional and inflammation biomarkers. A cross-sectional study was conducted among healthy children aged 10-12 years from Arab villages in Israel. Parents were interviewed regarding sociodemographic and children's health status. Body weight and height measurements were performed and weight categories were defined using the 2007 WHO growth curves. Blood samples were tested for complete blood count, levels of iron, ferritin, lipids, uric acid, and C-reactive protein (CRP). Overall, 146 children (59.0% males, mean age = 11.3 [SD = 0.5]) were enrolled. In total 43.8%, 14.1% and 42.3% of the participants had normal weight, overweight and obesity, respectively. A multivariable logistic regression model showed that children with overweight and obesity had lower iron, and HDL-C levels than children with normal weight. Levels of CRP, uric acid, LDL-C and lymphocytes were higher among children with overweight and obesity. In conclusion, our findings highlight the worse metabolic and nutritional status in overweight and obese children. Such markers play a role in metabolic syndrome, thus suggesting that metabolic syndrome might start in childhood.

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios of overweight children and adolescents

OBJECTIVE

This study aimed to compare neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio of overweight children and adolescents with the eutrophic ratios and to verify whether these ratios are associated with age, inflammation, Z-score of body mass index, and waist-to-height ratio.

METHODS

This is a cross-sectional study involving 64 overweight and 106 eutrophic children and adolescents. Data on weight, height, and waist circumference (body mass index and waist-to-height ratio), blood count (neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio), and high-sensitivity C-reactive protein were collected.

RESULTS

The mean age of participants was 8.4±3.2 years. The ratios did not differ between the overweight and non-overweight groups. The platelet-to-lymphocyte ratio has shown a direct and independent association with body mass index (p=0.031) and waist-to-height ratio (p=0.018), a fact not observed for neutrophil-to-lymphocyte ratio. The ultrasensitive C-reactive protein level was higher in the obesity group (p=0.003). Both ratios had a direct and independent association with age.

CONCLUSION

The ratios did not differ between the overweight and non-overweight groups. There was a direct and independent association of platelet-to-lymphocyte ratio with overweight, not observed in neutrophil-to-lymphocyte ratio. The ratios have significantly increased according to the age of the participants.