rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2025-28-1-47-53bucfhmrosped-1242Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESБиомаркеры хронического воспаления у детей с ожирением и их связь с осложнениями болезниBiomarkers of chronic inflammation in children with obesity and their association with complications of the diseasehttps://orcid.org/0000-0003-3329-6445СкворцоваОльга ВикторовнаSkvortsovaOlga V.

Аспирант каф. педиатрии ИПО ФГБОУ ВО «Самгму» Минздрава России; врач педиатр, врач – детский эндокринолог ГБУЗ «СОДКБ им. Н.Н. Ивановой»

e-mail: skvorcova_a@bk.ru

Graduate student of department department of Pediatrics of the Institution of professional education, Samara State Medical University; pediatrician, pediatric endocrinologist, Samara Regional Children’s Clinical Hospital named after N.N. Ivanova

e-mail: skvorcova_a@bk.ru

skvorcova_a@bk.ruhttps://orcid.org/0000-0003-0941-9871МигачеваНаталья БегиевнаMigachevaNataliya B.

Доктор мед. наук, зав. каф. педиатрии ИПО ФГБОУ ВО Самгму Минздрава России

e-mail: nbmigacheva@gmail.com

nbmigacheva@gmail.comhttps://orcid.org/0000-0002-2213-6334МихайловаЕвгения ГеннадьевнаMikhaylovaEvgeniya G.

Канд. мед. наук, доцент каф. педиатрии ИПО ФГБОУ ВО Самгму Минздрава России; зав. отделением детской эндокринологии ГБУЗ «СОДКБ им. Н.Н. Ивановой»

e-mail: e.mikhailova13@yandex.ru

e.mikhailova13@yandex.ruФГБОУ ВО «Самарский государственный медицинский университет»; ГБУЗ «Самарская областная детская клиническая больница им. Н.Н. Ивановой»Samara State Medical University; Samara Regional Children’s Clinical Hospital named after N.N. IvanovaФГБОУ ВО «Самарский государственный медицинский университет»Samara State Medical University2025030320252814753Copyright © Скворцова О.В., Мигачева Н.Б., Михайлова Е.Г., 20252025Скворцова О.В., Мигачева Н.Б., Михайлова Е.Г.Skvortsova O.V., Migacheva N.B., Mikhaylova E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/1242Актуальность

Актуальность. Распространённость детского ожирения и его осложнений определяет необходимость анализа различных механизмов формирования этих форм патологии, в том числе нарушений, реализующихся в хроническое неспецифическое воспаление (ХНВ) при ожирении.

Цель работы

Цель работы: определить изменения уровней воспалительных биомаркеров у детей с ожирением и их связь с осложнениями болезни.

Материалы и методы

Материалы и методы. Обследовано 211 детей школьного возраста, из них 188 больных с конституционально-экзогенным ожирением и 23 условно здоровых ребёнка, составивших контрольную группу. Средний возраст детей составил 14 лет. У всех детей определяли антропометрические параметры, уровень лейкоцитов, С-реактивного белка и скорость оседания эритроцитов, вычисляли индекс массы тела по формуле Кетле. Содержание интерлейкинов-1β, -6, -10, -18 и фактора некроза опухоли-α в крови выявляли иммуноферментным методом.

Результаты

Результаты. У больных ожирением с метаболическими осложнениями болезни значительно повышен уровень лейкоцитов, С-реактивного белка и интерлейкина-6 в крови по сравнению с детьми без осложнений. Установлены корреляции между уровнями воспалительных биомаркеров и различными осложнениями ожирения. Высокие уровни воспалительных маркеров у детей с осложнениями ожирения свидетельствуют о формировании ассоциированного с ожирением ХНВ на ранних этапах болезни.

Заключение

Заключение. Установленные закономерности можно использовать в качестве предикторов неблагоприятного течения ожирения у детей и ранних маркеров риска формирования осложнений.

Участие авторов

Участие авторов: Скворцова О.В., Мигачева Н.Б. — концепция и дизайн исследования; Скворцова О.В., Михайлова Е.Г. — сбор и обработка материала; Скворцова О.В. — статистическая обработка материала; Скворцова О.В., Мигачева Н.Б. — написание текста; Мигачева Н.Б., Михайлова Е.Г. — редактирование. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 16

Поступила 16.01.2025Принята к печати 30.01.2025Опубликована 28.02.2025

 

 

Relevance

Relevance. The prevalence of childhood obesity and its complications determine the need to analyze the various mechanisms of formation of these forms of pathology, including disorders that are realized in chronic nonspecific inflammation in obesity.

The aim of the study was to determine changes in the levels of inflammatory biomarkers in obese children and their association with complications of the disease.

Materials and methods

Materials and methods. There were examined two hundred eleven school-age children, including 188 patients with constitutionally exogenous obesity and 23 conditionally healthy children who made up the control group. The average age of the children was 14 years. Anthropometric parameters were determined in all children, body mass index (BMI) was calculated using the Ketle formula, the number of leukocytes, levels of C-reactive protein and erythrocyte sedimentation rate. The blood (interleukin (IL)-1β, IL-6, IL-10, IL-18) and tumor necrosis factor-α (TNFα) in the blood was determined by enzyme immunoassay.

Results

Results. Obese patients with metabolic complications of the disease showed significantly increased blood levels of leukocytes, C-reactive protein, and IL-6 when compared with children without complications. Correlations have been established between the levels of inflammatory biomarkers and various complications of obesity. High levels of inflammatory markers in children with complications of obesity indicate the formation of obesity-associated chronic nonspecific inflammation in the early stages of the disease.

Conclusion

Conclusion. The established patterns can be used as predictors of the unfavourable course of obesity in children and early markers of the risk of complications.

Contribution

Contribution: Skvortsova O.V., Migacheva N.B. — concept and design of the study; Skvortsova O.V., Mikhaylova E.G. — data collection and processing; Skvortsova O.V. — statistical processing of the data; Skvortsova O.V., Migacheva N.B. — writing the text; Migacheva N.B., Mikhaylova E.G. — editing the text. All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: January 16, 2025Accepted: January 30, 2025Published: February 28, 2025

детиконституционально-экзогенное ожирениеосложненияхроническое неспецифическое воспалениецитокиныдиагностикаchildrenconstitutionally exogenous obesitycomplicationschronic nonspecific inflammationcytokinesdiagnosisReferencesWaldrop S.W., Ibrahim A.A., Maya J., Monthe-Dreze C., Stanford F.C. Overview of pediatric obesity as a disease. Pediatr. Clin. North Am. 2024; 71(5): 761–79. https://doi.org/10.1016/j.pcl.2024.06.003Waldrop S.W., Ibrahim A.A., Maya J., Monthe-Dreze C., Stanford F.C. Overview of pediatric obesity as a disease. Pediatr. Clin. North Am. 2024; 71(5): 761–79. https://doi.org/10.1016/j.pcl.2024.06.003Mosca A., Volpe L.D., Sartorelli M.R., Comparcola D., Veraldi S., Alisi A., et al. Metabolic associated fatty liver disease in children and adolescents: mechanisms of a silent epidemic and therapeutic options. Curr. Pediatr. Rev. 2024; 20(3): 296–304. https://doi.org/10.2174/1573396319666230403121805Mosca A., Volpe L.D., Sartorelli M.R., Comparcola D., Veraldi S., Alisi A., et al. Metabolic associated fatty liver disease in children and adolescents: mechanisms of a silent epidemic and therapeutic options. Curr. Pediatr. Rev. 2024; 20(3): 296–304. https://doi.org/10.2174/1573396319666230403121805Cheng K.L., Wang S.W., Cheng Y.M., Hsieh T.H., Wang C.C., Kao J.H. Prevalence and clinical outcomes in subtypes of metabolic associated fatty liver disease. J. Formos. Med. Assoc. 2024; 123(1): 36–44. https://doi.org/10.1016/j.jfma.2023.07.010Cheng K.L., Wang S.W., Cheng Y.M., Hsieh T.H., Wang C.C., Kao J.H. Prevalence and clinical outcomes in subtypes of metabolic associated fatty liver disease. J. Formos. Med. Assoc. 2024; 123(1): 36–44. https://doi.org/10.1016/j.jfma.2023.07.010Adeva-Andany M.M., Domínguez-Montero A., Adeva-Contreras L., Fernández-Fernández C., Carneiro-Freire N., González-Lucán M. Body fat distribution contributes to defining the relationship between insulin resistance and obesity in human diseases. Curr. Diabetes Rev. 2024; 20(5): e160823219824. https://doi.org/10.2174/1573399820666230816111624Adeva-Andany M.M., Domínguez-Montero A., Adeva-Contreras L., Fernández-Fernández C., Carneiro-Freire N., González-Lucán M. Body fat distribution contributes to defining the relationship between insulin resistance and obesity in human diseases. Curr. Diabetes Rev. 2024; 20(5): e160823219824. https://doi.org/10.2174/1573399820666230816111624Taner S., Gezici E., Unal A., Tolunay O. The association of obesity and hyperuricemia with ambulatory blood pressure in children. Pediatr. Nephrol. 2025; 40(3): 787–96. https://doi.org/10.1007/s00467-024-06540-0Taner S., Gezici E., Unal A., Tolunay O. The association of obesity and hyperuricemia with ambulatory blood pressure in children. Pediatr. Nephrol. 2025; 40(3): 787–96. https://doi.org/10.1007/s00467-024-06540-0Скворцова О.В., Мигачева Н.Б., Михайлова Е.Г., Каткова Л.И. Оценка распространенности избытка массы тела и ожирения среди детей школьного возраста в г. Самаре. Медицинский вестник Юга России. 2022; 13(4): 106–13. https://doi.org/10.21886/2219-8075-2022-13-4-106-113 https://elibrary.ru/zzsgcfSkvortsova O.V., Migacheva N.B., Mikhaylova E.G., Katkova L.I. Assessment of the prevalence of overweight and obesity among school-age children in Samara. Meditsinskiy vestnik Yuga Rossii. 2022; 13(4): 106–13. https://doi.org/10.21886/2219-8075-2022-13-4-106-113 https://elibrary.ru/zzsgcf (in Russian)Гусейнова Р.М., Доровских А.В., Васюкова О.В., Шестакова Е.А., Окороков П.Л., Мокрышева Н.Г. Причины рецидива ожирения после снижения массы тела. Проблемы эндокринологии. 2024; 70(3): 67–73. https://doi.org10.14341/probl13275 https://elibrary.ru/gnqhwbGuseinova R.M., Dorovskikh A.V., Vasyukova O.V., Shestakova E.A., Okorokov P.L., Mokrysheva N.G. The causes of obesity relapse after weight loss. Problemy endokrinologii. 2024; 70(3): 67–73. https://doi.org10.14341/probl13275 https://elibrary.ru/gnqhwb (in Russian)Васюкова О.В., Окороков П.Л., Безлепкина О.Б. Современные стратегии лечения ожирения у детей. Проблемы эндокринологии. 2022; 68(6): 131–6. https://doi.org10.14341/probl13208 https://elibrary.ru/ervhywVasyukova O.V., Okorokov P.L., Bezlepkina O.B. Modern strategies for the treatment of childhood obesity. Problemy endokrinologii. 2022; 68(6): 131–6. https://doi.org10.14341/probl13208 https://elibrary.ru/ervhyw (in Russian)Lonardo A., Mantovani A., Lugari S., Targher G. Epidemiology and pathophysiology of the association between NAFLD and metabolically healthy or metabolically unhealthy obesity. Ann. Hepatol. 2020; 19(4): 359–66. https://doi.org/10.1016/j.aohep.2020.03.001Lonardo A., Mantovani A., Lugari S., Targher G. Epidemiology and pathophysiology of the association between NAFLD and metabolically healthy or metabolically unhealthy obesity. Ann. Hepatol. 2020; 19(4): 359–66. https://doi.org/10.1016/j.aohep.2020.03.001Tsatsoulis A., Paschou S.A. Metabolically healthy obesity: criteria, epidemiology, controversies, and consequences. Curr. Obes. Rep. 2020; 9(2): 109–20. https://doi.org/10.1007/s13679-020-00375-0Tsatsoulis A., Paschou S.A. Metabolically healthy obesity: criteria, epidemiology, controversies, and consequences. Curr. Obes. Rep. 2020; 9(2): 109–20. https://doi.org/10.1007/s13679-020-00375-0Barrea L., Muscogiuri G., Pugliese G., de Alteriis G., Colao A., Savastano S. Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) phenotypes in PCOS: association with endocrine-metabolic profile, adherence to the mediterranean diet, and body composition. Nutrients. 2021; 13(11): 3925. https://doi.org/10.3390/nu13113925Barrea L., Muscogiuri G., Pugliese G., de Alteriis G., Colao A., Savastano S. Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) phenotypes in PCOS: association with endocrine-metabolic profile, adherence to the mediterranean diet, and body composition. Nutrients. 2021; 13(11): 3925. https://doi.org/10.3390/nu13113925Kawai S., Yamakage H., Kotani K., Noda M., Satoh-Asahara N., Hashimoto K. Differences in metabolic characteristics between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) in weight reduction therapy. Endocr. J. 2023; 70(12): 1175–86. https://doi.org/10.1507/endocrj.EJ23-0189Kawai S., Yamakage H., Kotani K., Noda M., Satoh-Asahara N., Hashimoto K. Differences in metabolic characteristics between metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) in weight reduction therapy. Endocr. J. 2023; 70(12): 1175–86. https://doi.org/10.1507/endocrj.EJ23-0189Gokulakrishnan R., Delhikumar C.G., Senthilkumar G.P., Sahoo J., Kumar R.R. Chronic inflammatory markers in overweight and obese children: a cross-sectional analytical study. Indian J. Endocrinol. Metab. 2024; 28(5): 542–7. https://doi.org/10.4103/ijem.ijem_353_23.7Gokulakrishnan R., Delhikumar C.G., Senthilkumar G.P., Sahoo J., Kumar R.R. Chronic inflammatory markers in overweight and obese children: a cross-sectional analytical study. Indian J. Endocrinol. Metab. 2024; 28(5): 542–7. https://doi.org/10.4103/ijem.ijem_353_23.7Lyo V., Arriola J., Ahmed S.M., Mostaedi R., Akinjobi Z., Shamseddeen H.N., et al. Assessment of obesity-related metabolic conditions: a novel objective scoring system better informs metabolic disease severity. Surg. Obes. Relat. Dis. 2025; 21(3): 207–15. https://doi.org/10.1016/j.soard.2024.09.004Lyo V., Arriola J., Ahmed S.M., Mostaedi R., Akinjobi Z., Shamseddeen H.N., et al. Assessment of obesity-related metabolic conditions: a novel objective scoring system better informs metabolic disease severity. Surg. Obes. Relat. Dis. 2025; 21(3): 207–15. https://doi.org/10.1016/j.soard.2024.09.004Петеркова В.А., Безлепкина О.Б., Болотова Н.В., Богова Е.А., Васюкова О.В., Гирш Я.В. и др. Клинические рекомендации «Ожирение у детей». Проблемы эндокринологии. 2021; 67(5): 67–83. https://doi.org/10.14341/probl12802 https://elibrary.ru/ixizsvPeterkova V.A., Bezlepkina O.B., Bolotova N.V., Bogova E.A., Vasyukova O.V., Girsh Ya.V., et al. Clinical guidelines «Obesity in children». Problemy endokrinologii. 2021; 67(5): 67–83. https://doi.org/10.14341/probl12802 https://elibrary.ru/ixizsv (in Russian)Yang H., Ying J., Zu T., Meng X.M., Jin J. Insights into renal damage in hyperuricemia: focus on renal protection (review). Mol. Med. Rep. 2025; 31(3): 59. https://doi.org/10.3892/mmr.2024.13424Yang H., Ying J., Zu T., Meng X.M., Jin J. Insights into renal damage in hyperuricemia: focus on renal protection (review). Mol. Med. Rep. 2025; 31(3): 59. https://doi.org/10.3892/mmr.2024.13424Gul A., Yilmaz R. Determination of inflammation by TNF-alpha and IL-10 levels in obese children and adolescents. Nutr. Hosp. 2024; 41(4): 788–92. https://doi.org/10.20960/nh.05064Gul A., Yilmaz R. Determination of inflammation by TNF-alpha and IL-10 levels in obese children and adolescents. Nutr. Hosp. 2024; 41(4): 788–92. https://doi.org/10.20960/nh.05064Bader-Meunier B. Immuno-inflammatory involvement of adipose tissue in children. Ann. Endocrinol. (Paris). 2024; 85(3): 211–3. https://doi.org/10.1016/j.ando.2024.04.001Bader-Meunier B. Immuno-inflammatory involvement of adipose tissue in children. Ann. Endocrinol. (Paris). 2024; 85(3): 211–3. https://doi.org/10.1016/j.ando.2024.04.001Романцова Т.И., Сыч Ю.П. Иммунометаболизм и метавоспаление при ожирении. Ожирение и метаболизм. 2019; 16(4): 3–17. https://doi.org/10.14341/omet12218 https://elibrary.ru/gifrwjRomantsova T.R., Sych Yu.P. Immunometabolism and metainflammation in obesity. Ozhirenie i metabolizm. 2019; 16(4): 3–17. https://doi.org/10.14341/omet12218 https://elibrary.ru/gifrwj (in Russian)Spoto B., Di Betta E., Pizzini P., Lonardi S., Mallamaci F., Tripepi G., et al. Inflammation biomarkers and inflammatory genes expression in metabolically healthy obese patients. Nutr. Metab. Cardiovasc. Dis. 2023; 33(3): 584–91. https://doi.org/10.1016/j.numecd.2022.12.008Spoto B., Di Betta E., Pizzini P., Lonardi S., Mallamaci F., Tripepi G., et al. Inflammation biomarkers and inflammatory genes expression in metabolically healthy obese patients. Nutr. Metab. Cardiovasc. Dis. 2023; 33(3): 584–91. https://doi.org/10.1016/j.numecd.2022.12.008Cobos-Palacios L., Ruiz-Moreno M.I., Vilches-Perez A., Vargas-Candela A., Muñoz-Úbeda M., Benítez Porres J., et al. Metabolically healthy obesity: Inflammatory biomarkers and adipokines in elderly population. PLoS One. 2022; 17(6): e0265362. https://doi.org/10.1371/journal.pone.026536210Cobos-Palacios L., Ruiz-Moreno M.I., Vilches-Perez A., Vargas-Candela A., Muñoz-Úbeda M., Benítez Porres J., et al. Metabolically healthy obesity: Inflammatory biomarkers and adipokines in elderly population. PLoS One. 2022; 17(6): e0265362. https://doi.org/10.1371/journal.pone.026536210Zhao D., Cui H., Shao Z., Cao L. Abdominal obesity, chronic inflammation and the risk of non-alcoholic fatty liver disease. Ann. Hepatol. 2023; 28(4): 100726. https://doi.org/10.1016/j.aohep.2022.100726Zhao D., Cui H., Shao Z., Cao L. Abdominal obesity, chronic inflammation and the risk of non-alcoholic fatty liver disease. Ann. Hepatol. 2023; 28(4): 100726. https://doi.org/10.1016/j.aohep.2022.100726Shin S.H., Lee Y.J., Lee Y.A., Kim J.H., Lee S.Y., Shin C.H. High-sensitivity C-reactive protein is associated with prediabetes and adiposity in Korean youth. Metab. Syndr. Relat. Disord. 2020; 18(1): 47–55. https://doi.org/10.1089/met.2019.0076.16Shin S.H., Lee Y.J., Lee Y.A., Kim J.H., Lee S.Y., Shin C.H. High-sensitivity C-reactive protein is associated with prediabetes and adiposity in Korean youth. Metab. Syndr. Relat. Disord. 2020; 18(1): 47–55. https://doi.org/10.1089/met.2019.0076.16Hoffman R.P., Yu C.Y. Hematologic and biochemical inflammatory markers increase with body mass and positively correlate in adolescents. Pediatr. Res. 2024; 95(1): 223–6. https://doi.org/10.1038/s41390-023-02769-xHoffman R.P., Yu C.Y. Hematologic and biochemical inflammatory markers increase with body mass and positively correlate in adolescents. Pediatr. Res. 2024; 95(1): 223–6. https://doi.org/10.1038/s41390-023-02769-xReyes-Farias M., Fernández-García P., Corrales P., González L., Soria-Gondek A., Martínez E., et al. Interleukin-16 is increased in obesity and alters adipogenesis and inflammation in vitro. Front. Endocrinol. (Lausanne). 2024; 15: 1346317. https://doi.org/10.3389/fendo.2024.1346317Reyes-Farias M., Fernández-García P., Corrales P., González L., Soria-Gondek A., Martínez E., et al. Interleukin-16 is increased in obesity and alters adipogenesis and inflammation in vitro. Front. Endocrinol. (Lausanne). 2024; 15: 1346317. https://doi.org/10.3389/fendo.2024.1346317Bryl E., Hanć T., Szcześniewska P., Dutkiewicz A., Dmitrzak-Węglarz M., Słopień A. The relation between prenatal stress, overweight and obesity in children diagnosed according to BMI and percentage fat tissue. Eat. Weight Disord. 2022; 27(7): 2759–73. https://doi.org/10.1007/s40519-022-01416-4Bryl E., Hanć T., Szcześniewska P., Dutkiewicz A., Dmitrzak-Węglarz M., Słopień A. The relation between prenatal stress, overweight and obesity in children diagnosed according to BMI and percentage fat tissue. Eat. Weight Disord. 2022; 27(7): 2759–73. https://doi.org/10.1007/s40519-022-01416-4Menendez A., Wanczyk H., Walker J., Zhou B., Santos M., Finck C. Obesity and adipose tissue dysfunction: from pediatrics to adults. Genes (Basel). 2022; 13(10): 1866. https://doi.org/10.3390/genes13101866Menendez A., Wanczyk H., Walker J., Zhou B., Santos M., Finck C. Obesity and adipose tissue dysfunction: from pediatrics to adults. Genes (Basel). 2022; 13(10): 1866. https://doi.org/10.3390/genes13101866Kostopoulou E., Kalavrizioti D., Davoulou P., Sinopidis X., Papachristou E., Goumenos D.S., et al. Soluble urokinase plasminogen activator receptor (suPAR) in children with obesity or type 1 diabetes as a marker of endothelial dysfunction: a cross-sectional study. Eur. J. Pediatr. 2024; 183(5): 2383–9. https://doi.org/10.1007/s00431-024-05496-5Kostopoulou E., Kalavrizioti D., Davoulou P., Sinopidis X., Papachristou E., Goumenos D.S., et al. Soluble urokinase plasminogen activator receptor (suPAR) in children with obesity or type 1 diabetes as a marker of endothelial dysfunction: a cross-sectional study. Eur. J. Pediatr. 2024; 183(5): 2383–9. https://doi.org/10.1007/s00431-024-05496-5Stinson S.E., Kromann Reim P., Lund M.A.V., Lausten-Thomsen U., Aas Holm L., Huang Y., et al. The interplay between birth weight and obesity in determining childhood and adolescent cardiometabolic risk. EBioMedicine. 2024; 105: 105205. https://doi.org/10.1016/j.ebiom.2024.105205Stinson S.E., Kromann Reim P., Lund M.A.V., Lausten-Thomsen U., Aas Holm L., Huang Y., et al. The interplay between birth weight and obesity in determining childhood and adolescent cardiometabolic risk. EBioMedicine. 2024; 105: 105205. https://doi.org/10.1016/j.ebiom.2024.105205

The authors declare that there are no conflicts of interest present.