Biomarkers of chronic inflammation in children with obesity and their association with complications of the disease

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. 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. 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. 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:
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. The study had no sponsorship.

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

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

1. Waldrop 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.2024.06.003

2. Mosca 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/10.2174/1573396319666230403121805

3. Cheng 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.2023.07.010

4. Adeva-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/10.2174/1573399820666230816111624

5. Taner 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/s00467-024-06540-0

6. Skvortsova 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)

7. Guseinova 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)

8. Vasyukova 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)

9. 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.2020.03.001

10. Tsatsoulis 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/s13679-020-00375-0

11. Barrea 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/nu13113925

12. Kawai 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.EJ23-0189

13. Gokulakrishnan 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_23.7

14. Lyo 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.2024.09.004

15. Peterkova 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)

16. 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.2024.13424

17. Gul 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.05064

18. Bader-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.2024.04.001

19. Romantsova 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)

20. 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.2022.12.008

21. Cobos-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.026536210

22. Zhao 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.2022.100726

23. Shin 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.2019.0076.16

24. Hoffman 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-x

25. Reyes-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.2024.1346317

26. Bryl 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/s40519-022-01416-4

27. Menendez 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/genes13101866

28. Kostopoulou 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/s00431-024-05496-5

29. Stinson 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