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Early Inflammatory Status Related to Pediatric Obesity
Cristina Oana Mărginean1, Lorena Elena Meliţ1, Dana Valentina Ghiga2
1Department of Pediatrics, University of Medicine, Pharmacy, Sciences, and Technology, Târgu Mureş, Romania.
Insights
Childhood obesity is linked to increased inflammation, with overweight/obese children showing higher leukocyte, lymphocyte, erythrocyte, and platelet counts. These findings highlight the inflammatory status associated with pediatric obesity.
Area of Science:
- Pediatric Endocrinology
- Immunology
- Public Health
Background:
- Obesity is characterized by chronic inflammation originating in adipose tissue, involving immune cell activity.
- Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are recognized as accessible biomarkers for subclinical inflammation.
Purpose of the Study:
- To investigate early inflammatory markers in children with overweight and obesity.
- To assess the correlation between Body Mass Index (BMI) and various laboratory and inflammatory parameters in pediatric patients.
Main Methods:
- A prospective study involving 164 children (5-18 years) divided into overweight/obese (BMI percentile ≥85) and normal BMI groups.
- Evaluated correlations between BMI and complete blood count (CBC), erythrocyte sedimentation rate (ESR), transaminases, total protein, albumin, blood glucose, inflammatory biomarkers, NLR, PLR, and abdominal ultrasound findings.
Main Results:
- Overweight/obese children exhibited significantly higher levels of leukocytes, lymphocytes, erythrocytes, platelets, C-reactive protein (CRP), and transaminases compared to normal BMI children.
- No significant differences were observed in neutrophil, hemoglobin, albumin, total protein, or glycemia levels between the groups.
- Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) did not show significant differences between the overweight/obese and normal BMI groups.
Conclusions:
- Pediatric obesity is associated with a systemic low-grade inflammatory state.
- Elevated leukocyte, lymphocyte, erythrocyte, and platelet levels in overweight/obese children indicate an inflammatory status.
- Further research in pediatric obesity is crucial for developing preventive strategies against adult complications.
Abstract:
Background: Obese individuals are often in a chronic inflammatory condition due to the malfunction of immune-related activities in the adipose tissue, involving a transient infiltration of neutrophils within the abdominal fat and their binding to adipocytes. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are considered cost-effective markers for the detection of subclinical inflammation. Our study intends to assess the early stages of inflammation associated with overweight and obesity in children. Materials and Methods: We performed a prospective study with 164 children, aged between 5 and 18 years, admitted to a Pediatric Tertiary Hospital in Romania between January 2018 and January 2019. The patients were divided according to body mass index (BMI) into two groups: Group 1: 77 overweight and obese children (BMI percentile ≥85), and Group 2: 87 children with a normal BMI, in order to evaluate the correlation between BMI and laboratory parameters (CBC, ESR, transaminase, total protein, albumin, and blood glucose levels), inflammatory biomarkers, NLR and PLR, and changes in abdominal ultrasound findings. Results: We found that the leukocyte, lymphocyte, erythrocyte, platelet, CRP, and transaminase levels were significantly higher in the overweight/obese group (p = 0.0379, p = 0.0002, p = 0.0003, p = 0.0006, p < 0.0001, p = 0.0332, and p < 0.0001, respectively). No significant statistical differences between the two groups in terms of neutrophil, hemoglobin, albumin, total protein, and glycemia levels were noted (p > 0.05). Moreover, NLR and PLR did not differ significantly between the two groups (p = 0.4674 and p = 0.9973, respectively). Conclusions: Obesity is associated with systemic low-grade inflammation which is reaching alarming rates worldwide among both children and adults. Our study proved that leukocyte, lymphocyte, erythrocyte, and platelet levels are significantly higher in overweight/obese children, emphasizing the inflammatory status related to this condition. Therefore, obesity-related studies involving pediatric patients are of major interest in order to develop appropriate methods to prevent the development of further complications in adulthood.
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