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Relationship between severe obesity and gut inflammation in children: what's next?
Maria Immacolata Spagnuolo1, Maria Pia Cicalese, Maria Angela Caiazzo
1Department of Paediatrics University Federico II, Naples, Italy. mispagnu@unina.it
Insights
Obese children frequently have glucose abnormalities and inflammation. Gut and systemic inflammation correlate with these glucose issues, highlighting a link between obesity, inflammation, and metabolic dysfunction in pediatric populations.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Metabolic Syndrome
Background:
- Obesity is increasingly linked to gut inflammation in preliminary studies.
- Understanding this association is crucial for pediatric health outcomes.
Purpose of the Study:
- To determine the prevalence of glucose abnormalities in severely obese children.
- To investigate the correlation between systemic and intestinal inflammation and glucose metabolism in this cohort.
Main Methods:
- Thirty-four severely obese children (BMI >95th percentile) underwent screening.
- Tests included oral glucose tolerance test (OGTT), C-reactive protein (CRP), fecal calprotectin, and rectal nitric oxide (NO).
Main Results:
- 71% of children exhibited glucose abnormalities, including type 2 diabetes (29%), impaired fasting glucose (58%), and impaired glucose tolerance (37.5%).
- Elevated CRP (73.5%), fecal calprotectin (47%), and nitric oxide (88%) were common.
- Significant correlations were found between BMI z-score and CRP, and between inflammation markers and abnormal glucose metabolism.
Conclusions:
- Severely obese children show a high prevalence of glucose abnormalities.
- Systemic and intestinal inflammation markers are correlated with glucose abnormalities in these children, suggesting a shared inflammatory pathway.
Background:
Preliminary evidence suggests an association between obesity and gut inflammation.
Aims:
To evaluate the frequency of glucose abnormalities and their correlation with systemic and intestinal inflammation in severely obese children.
Patients And Methods:
Thirty-four children (25 males; median age 10.8 ± 3.4 yrs) with severe obesity (BMI >95%) were screened for diabetes with oral glucose tolerance test (OGTT), systemic inflammation with C-reactive protein (CRP) and gut inflammation with rectal nitric oxide (NO) and faecal calprotectin.
Results:
BMI ranged from 23 to 44 kg/m2, and BMI z-score between 2.08 e 4.93 (median 2.69 ± 0.53). Glucose abnormalities were documented in 71% of patients: type 2 diabetes in 29%, impaired fasting glucose (IFG) in 58%, and impaired glucose tolerance (IGT) in 37.5%. Thirty-one patients (91%) were hyperinsulinemic. CRP was increased in 73.5% with a correlation between BMI z-score and CRP (p 0.03). Faecal calprotectin was increased in 47% patients (mean 77 ± 68), and in 50% of children with abnormal glucose metabolism (mean 76 ± 68 μg/g), with a correlation with increasing BMI z-score. NO was pathological in 88%, and in 87.5% of glucose impairment (mean 6.8 ± 5 μM).
Conclusions:
In this study, the prevalence of glucose abnormalities in obese children is higher than in other series; furthermore, a correlation is present between markers of systemic and intestinal inflammation and glucose abnormalities.
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