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Inflammation-Related Markers and Thyroid Function Measures in Pediatric Patients: Is the Grade of Obesity Relevant?
Ioana Țaranu1,2, Cecilia Lazea2,3, Victoria Creț2
1Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, Louis Pasteur Str., No. 6, 400349 Cluj-Napoca, Romania.
Insights
Pediatric obesity is linked to increased inflammation markers like white blood cell counts. Overweight and obese children may also develop early thyroid issues, including hypothyroidism.
Area of Science:
- Pediatric Endocrinology
- Clinical Immunology
- Obesity Research
Background:
- Pediatric overweight and obesity are growing concerns with potential links to inflammation and endocrine dysfunction.
- Inflammation markers and thyroid function are crucial indicators of metabolic and endocrine health in children.
Purpose of the Study:
- To investigate the relationship between weight status (overweight, obese, severely obese) and inflammation markers in pediatric patients.
- To assess thyroid function in pediatric patients with varying degrees of overweight and obesity.
- To identify potential early indicators of inflammation and thyroid dysfunction in pediatric obesity.
Main Methods:
- Retrospective analysis of pediatric patients diagnosed with overweight or obesity between January 2017 and January 2019.
- Calculation of inflammation markers: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII).
- Analysis of white blood cells (WBC), absolute lymphocyte count, and absolute polymorphonuclear neutrophils (PMNCs) based on Body Mass Index (BMI)-for-age z-score categories.
- Evaluation of thyroid function tests, including thyroid-stimulating hormone (TSH) and free thyroxine (fT4).
Main Results:
- Severely obese patients exhibited significantly higher white blood cell (WBC) counts compared to overweight patients.
- Absolute lymphocyte count showed a significant association with the degree of obesity in children.
- Absolute polymorphonuclear neutrophils (PMNCs) count was significantly higher in severely obese adolescents than in overweight adolescents.
- Elevated thyroid-stimulating hormone (TSH) was found in 8.19% of patients, and 3.36% presented with low free thyroxine and elevated TSH, suggesting subclinical or overt hypothyroidism.
Conclusions:
- Total absolute WBC count may serve as a reliable inflammation marker in pediatric obesity, warranting further validation.
- Overweight and obese children and adolescents are at risk for developing subclinical and overt hypothyroidism from an early age.
- Weight status significantly impacts inflammation markers and thyroid function in pediatric populations, highlighting the need for early monitoring and intervention.
Abstract:
We aimed to investigate the effect of weight status on inflammation-related markers and thyroid function tests in overweight and obese pediatric patients. Children and adolescents diagnosed between January 2017 and January 2019 with overweight or obesity were included in the study. Neutrophil-to-lymphocyte ratio (NLR), platelet-to lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) were calculated for the groups defined according to Body Mass Index (BMI)-for-age z-score: overweight (≥1 BMI-for-age z-score), obese (≥2 BMI-for-age z-score) and severely obese (≥3 BMI-for-age z-score). Severely obese patients had significantly higher value of white blood cells (WBC) counts (median = 7.92) compared with overweight patients (7.37, p = 0.014). Absolute lymphocyte count was significantly associated with obesity degree in children (Spearman's Rho coefficient ρ = 0.228. p = 0.035), whereas absolute polymorphonuclear neutrophils (PMNCs) count was significantly higher in severely obese adolescents than overweight adolescents (overweight: 4.04 vs. severely obese: 5.3 (p = 0.029)). In 8.19% of patients an elevated thyroid-stimulating hormone (TSH) level was found, and 3.36% of patients had a low level of free thyroxine with an elevated level of TSH. Total absolute WBC count may be a reliable inflammation-related marker in obese pediatric patients without metabolic syndrome, but needs to be validated in the context of all possible covariates. Subclinical and overt hypothyroidism may develop from an early age in overweight or obese patients.
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