Inflammation-Related Markers and Thyroid Function Measures in Pediatric Patients: Is the Grade of Obesity Relevant?

Ioana Țaranu,Cecilia Lazea,Sorana D Bolboacă,Mihaela Iancu,Nicoleta Răcătăianu,Victoria Creț

doi:10.3390/diagnostics11030485

Ioana Țaranu, Cecilia Lazea + Show 4 more

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https://doi.org/10.3390/diagnostics11030485

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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.

Highlights

Obesity is associated with increased mortality in adulthood [1] and the risk of cardiometabolic multimorbidity rises from twice in overweight to 15 times in severely obese individuals (WHO class II and III obesity, where WHO = World Health Organization) [2]
We found no significant differences in mean values of Neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII) and platelet-to lymphocyte ratio (PLR) between groups are described in Figure the three weight groups
± standard deviation (SD) we found no significant association with weight status (Fisher’s-Exact test, p for obese = 0.96 ± 0.18, mean ±SD for severe obese = 1.02 ± 0.21), nor in adolescents (one- In 10 (8.19%)

Summary

Introduction

Obesity is associated with increased mortality in adulthood [1] and the risk of cardiometabolic multimorbidity (defined as the presence of at least two out of type 2 diabetes, coronary heart disease, and stroke) rises from twice in overweight to 15 times in severely obese individuals (WHO class II and III obesity, where WHO = World Health Organization) [2]. Consensus upon definition of cardiometabolic risk (CMR) in children has not been reached [3,4,5], but adiposity, lipid profile, glycaemia, insulin level and blood pressure are common elements of the CMR cluster across studies and higher degrees of obesity are associated to an increase in metabolic risk [6,7]. In the American pediatric population, based on CDC (Centers for Disease Control and Prevention) thresholds, a new definition for obesity has been recently proposed: class I obesity (≥95th percentile to

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