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PEDIATRICS Vol. 107 No. 1 January 2001, p. e13

ELECTRONIC ARTICLE:
Low-Grade Systemic Inflammation in Overweight Children

Received May 3, 2000; accepted Aug 16, 2000.

Marjolein Visser*, Dagger , Lex M. Bouter*, Geraldine M. McQuillan§, Mark H. Wenerparallel , and Tamara B. HarrisDagger

From the * Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands; Dagger  Epidemiology, Demography, and Biometry Program, National Institute on Aging, National Institutes of Health, Bethesda, Maryland; § National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland; and the parallel  Departments of Laboratory Medicine and Medicine, University of Washington, Seattle, Washington.

Objective.  Human adipose tissue expresses and releases the proinflammatory cytokine interleukin-6, potentially inducing low-grade systemic inflammation in persons with excess body fat. To limit potential confounding by inflammation-related diseases and subclinical cardiovascular disease, we tested the hypothesis that overweight is associated with low-grade systemic inflammation in children.

Design and Setting.  The third National Health and Nutrition Examination Survey, 1988-1994, a representative sample of the US population.

Participants.  A total of 3512 children 8 to 16 years of age.

Outcome Measures.  Elevated serum C-reactive protein concentration (CRP; >= .22 mg/dL) and white blood cell count (109 cells/L).

Results.  Elevated CRP was present in 7.1% of the boys and 6.1% of the girls. Overweight children (defined as having a body mass index or a sum of 3 skinfolds (triceps, subscapula, and supra-iliac) above the gender-specific 85th percentile) were more likely to have elevated CRP than were their normal-weight counterparts. After adjustment for potential confounders, including smoking and health status, the odds ratio (OR) was 3.74 (95% confidence interval [CI]: 1.66-8.43) for overweight boys and the OR was 3.17 (95% CI: 1.60-6.28) for overweight girls, based on the body mass index. Based on the sum of 3 skinfolds, these ORs were 5.11 (95% CI: 2.36-11.06) and 2.89 (95% CI: 1.49-5.59) for boys and girls, respectively. Overweight was also associated with statistically significant higher white blood cell counts. The results were similar when restricted to healthy, nonsmoking, nonestrogen-using children.

Conclusions.  In children 8 to 16 years of age, overweight is associated with higher CRP concentrations and higher white blood cell counts. These findings suggest a state of low-grade systemic inflammation in overweight children. inflammation, obesity, children. .




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