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Systemic inflammatory indices and glucose homeostasis in children with obesity: evidence from oral glucose tolerance

Nurdan Çiftci1, Rabia Meral2

  • 1Department of Pediatric Endocrinology, Konya City Hospital, Konya, Türkiye.

European Journal of Pediatrics
|August 12, 2026
PubMed

Insights

The systemic immune-inflammation index (SII) was unexpectedly higher in children with obesity who had normal blood sugar levels, not those with dysglycemia. These findings suggest SII is not a reliable biomarker for detecting glucose metabolism abnormalities in this population.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Health
  • Inflammation Biomarkers

Background:

  • Chronic low-grade inflammation is linked to metabolic dysfunction in obesity.
  • Systemic immune-inflammation index (SII) and pan-immune-inflammation value (PIV) are emerging inflammation biomarkers.
  • Limited pediatric data exist on SII/PIV associations with oral glucose tolerance test (OGTT)-defined glucose metabolism.

Purpose of the Study:

  • To investigate the association between SII and PIV with glucose metabolism abnormalities in children with obesity.
  • To evaluate the utility of SII and PIV as potential biomarkers for dysglycemia in pediatric obesity.

Main Methods:

  • Retrospective cross-sectional study of 238 children and adolescents with obesity undergoing OGTT.
  • Calculation of SII and PIV from complete blood counts.
  • Statistical analysis using ANCOVA adjusted for BMI-SDS, age, sex, and pubertal status.

Main Results:

  • BMI-SDS positively correlated with both SII and PIV.
  • No significant associations were found between SII/PIV and HbA1c, lipid profile, HOMA-IR, Matsuda index, or insulinogenic index.
  • Adjusted SII levels were significantly higher in the normoglycemic group compared to the dysglycemic group (p=0.025).

Conclusions:

  • The study found higher SII values in normoglycemic participants, an unexpected result requiring further investigation.
  • The findings do not support the use of SII or PIV as diagnostic or screening biomarkers for dysglycemia in children with obesity.
  • Neither inflammatory index correlated with OGTT-derived insulin sensitivity or early insulin secretion, limiting their clinical utility.

Keywords:
Childhood obesityDysglycemiaInflammationOGTTPan-immune-inflammation valueSystemic immune-inflammation index

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