Reduced antioxidant capacity and increased subclinical inflammation markers in prepubescent obese children and their relationship with nutritional markers and metabolic parameters

Figures & data

Table 1 Comparison of demographic and anthropometric characteristics in underweight, normal-weight and obese children

Characteristics	Underweight children	Healthy children	Obese children	P* Value
	mean ± SD (range)	mean ± SD (range)	mean ± SD (range)
Children (n)	80	80	90
Gender
Female	39 (48.75)	41 (51.25)	49 (54.5)
Male	41 (51.25)	39 (48.75)	41 (45.5)	0.993
Age (years)	7.0 ± 2.6 (2–11)	7.2 ± 2.7 (3–11)	7.4 ± 2.7 (2–11)	0.840
Weight, kg	20.8 ± 7.4 (9.5–36.9)	25.8 ± 10.0 (12.5–59)	52.1 ± 16.5 (19.1–86)	<0.001
Weight, z-score	−1.47 ± 0.9 (−3.9 : 0.48)	0.17 ± 0.68 (−1.2:1.9)	2.15 ± 0.78 (−0.04:4.13)	<0.001
Height, cm	120.6 ± 19.1 (82–160)	122.0 ± 17.1 (90–159)	141.8 ± 16.6 (92.7–170)	<0.001
Height, z-score	−0.41 ± 1.0 (−2.9:2.3)	0.01 ± 0.84 (−1.5:2.0)	0.90 ± 0.9 (−1.6:2.7)	<0.001
BMI, kg/m^2	13.8 ± 1 (11.7–17.1)	16.75 ± 1.90 (14.2–21.8)	25.78 ± 4.2 (19.6–43.6)	<0.001
BMI-z score	−1.91 ± 0.8 (−4.9:−1.1)	0.23 ± 0.7 (−1.5:1.7)	2.32 ± 0.6 (0.9:4.5)	<0.001
BMI per.	6.3 ± 9.7 (0–24.3)	54.9 ± 22.50 (13.3–91.6)	98.1 ± 1.8 (95–100)	<0.001

BMI: body mass index, The data are expressed as number, mean values ± standard deviation (range), One-way ANOVA test was used for correlation analysis, P < 0.05.

Table 2 Comparison of laboratory characteristics of subjects according to BMI stage group

Parameters	Underweight children	Healthy children	Obese children	P* Value
	mean ± SD (range)	mean ± SD (range)	mean ± SD (range)
Hb (g/dl)	12.46 ± 0.9 (9.6–14.8)	12.31 ± 0.9 (10.4–14)	12.65 ± 0.9 (10.4–14.7)	0.790
Hct	36.9 ± 2.55 (60–89.4)	36.6 ± 2.6 (65–87.6)	37.8 ± 3.5 (62.2–90.6)	0.055
fT4 (pmol/l)	15.27 ± 1.9 (10.6–19.9)	14.02 ± 2.13 (6.3–18.6)	13.63 ± 2.26 (2.57–18.9)	<0.001
TSH (IU/ml)	2.27 ± 0.91 (0.9–4.57)	3.04 ± 1.44 (0.7–6.7)	3.22 ± 2.26 (1.08–14.8)	<0.001
Albumin (g/dl)	4.43 ± 0.24 (4–5.2)	4.39 ± 0.22 (4–4.9)	4.44 ± 0.22 (4.1–5.2)	0.880
Vitamin B12 (pg/ml)	402.6 ± 190.2 (101–1582)	459.7 ± 178.8 (173–970)	399.5 ± 144.3 (104–721)	0.060
Ferritin (ng/ml)	32.02 ± 22.69 (4.1–107.7)	29.1 ± 21.1 (3.2–107.7)	29.38 ± 15.0 (5.4 ± 80.3)	0.606
Glucose (mg/dl)	87.6 ± 8.1 (59–99)	87.98 ± 6.3 (73–98)	92.81 ± 5.4 (79–103)	<0.001
Insulin (IU/ml)	8.1 ± 5.2 (1.03–26.5)	10.11 ± 6.1 (1.50–33.1)	19.36 ± 13.8 (3.9–82.5)	<0.001
HOMA-IR	1.78 ± 1.2 (0.19–6.3)	2.18 ± 1.35 (0.3–6.7)	4.44 ± 3.29 (0.9–19.79)	<0.001
HOMA-β	115.1 ± 139 (−854:414)	160.7 ± 107 (25–621)	241.7 ± 136.4 (55.5–873)	<0.001
Triglyceride (mg/dl)	65.7 ± 21.0 (36–135)	62.9 ± 17.3 (32–113)	92.2 ± 28.5 (32–148)	<0.001
Total cholesterol (mg/dl)	153 ± 17.2 (109–188)	154.6 ± 20 (108–223)	166 ± 28.7 (105–233)	<0.001

Hb: hemoglobin, fT4: Free thyroxin, TSH: thyroid stimulating hormone, HOMA-IR: Homeostatic model of assistance of insulin resistance, HOMA-β: Homeostatic model assessment of β-cell function.

The data are expressed as number, mean values ± standard deviation (range), One-way ANOVA test was used for correlation analysis, P < 0.05.

Table 3 Comparison of proinflammatory indicators of subjects according to BMI stage group

Parameters	Underweight children	Healthy children	Obese children	P* Value
	mean ± SD (range)	mean ± SD (range)	mean ± SD (range)
WBC, ×10^3/µl	7.84 ± 2.14 (4.23–12.77)	7.75 ± 1.95 (4.58–12.30)	8.72 ± 1.99 (3.86–13.05)	0.035
NC, ×10^3/µl	3.82 ± 1.78 (1.20–9.6)	3.52 ± 1.47 (1.23–9.45)	4.58 ± 1.84 (1.00–10.73)	<0.001
LC, ×10^3/µl	3.13 ± 1.00 (1.40–6.13)	3.30 ± 1.10 (1.16–8.48)	3.00 ± 0.90 (1.17–6.19)	0.187
NLR	1.35 ± 0.80 (0.29–4.58)	1.20 ± 0.77 (0.29–4.68)	1.73 ± 1.18 (0.26–8.72)	<0.001
CRP, mg/l	1.50 ± 1.39 (0.0–9.0)	1.64 ± 1.22 (0.0–9.0)	4.11 ± 3.10 (0.0–15)	<0.001
TAS	1.33 ± 0.23 (1.01–1.98)	1.29 ± 0.21 (0.9–1.99)	1.19 ± 0.25 (0.9–1.99)	<0.001
TOS	11.27 ± 4.8 (6.78–32.1)	10.27 ± 3.34 (6.14–32.22)	11.33 ± 5.12 (6.78–32.12)	0.289
OSI	0.86 ± 0.39 (0.46–2.72)	0.81 ± 0.35 (0.31–3.29)	0.96 ± 0.48 (0.10–3.15)	0.075
Total thiol	0.36 ± 0.055 (0.14–0.48)	0.36 ± 0.04 (0.28–0.52)	0.33 ± 0.03 (0.28–0.46)	<0.001

WBC: White blood cell, NC: neutrophil count, LC: lymphocyte count, NLR: neutrophil/lymphocyte ratio, CRP: C-reactive protein, TAS: Total antioxidant status (mmol equiv/l Trolox), TOS: Total oxidant status (μmol H₂O₂ equiv/l), OSI: Oxidative stress index (arbitrary unıts), Total thiol (–SH free sulfhydryl groups) (mmol/l).

The data are expressed as number, mean values ± standard deviation (range), One-way ANOVA test was used for correlation analysis, P < 0.05.

Figure 1 Scatter plot figures for Pearson's correlation of WBC, WBC subtypes, and NLR with BMI in overall population. WBC: White blood cell, BMI: Body mass index, NLR: Neutrophil–lymphocyte ratio, blood cell is expressed as ×10³/µl.

Figure 2 Pearson's correlation of TAS, TOS, OSI and Total thiol with BMI. TAS: Total antioxidant status (mmol equiv/l Trolox), TOS: Total oxidant status (μmol H₂O₂ equiv/l), OSI: Oxidative stress index (arbitrary units), Total thiol (mmol/l).

Table 4 The results of Pearson's correlation between proinflammatory markers and other anthropometric and metabolic parameters

	r	P		r	P
WBC correlations with			NLR correlations with
CRP	0.312**	<0.001	HOMA-IR	0.223**	0.001
Neutrophil	0.822**	<0.001	HOMA-β	0.174**	0.008
Lymphocyte	0.399**	<0.001	Insulin	0.219**	0.001
NLR	0.453**	<0.001	Glucose	0.150*	0.023
TAS	−0.145*	0.028	CRP	0.323**	<0.001
			WBC	0.453**	<0.001
Neutrophil correlations with			Neutrophil	0.825**	<0.001
HOMA-IR	0.188**	0.004	Lymphocyte	−0.533**	<0.001
HOMA-β	0.181**	0.006	TAS	−0.158*	0.016
Insulin	0.188**	0.004	TOS	0.140*	0.034
CRP	0.389**	<0.001	OSI	0.189**	0.004
WBC	0.822**	<0.001	CRP correlations with
Lymphocyte	−0.155*	0.019	BMI	0.471**	<0.001
NLR	0.825**	<0.001	HOMA-IR	0.385**	<0.001
TAS	−0.179**	0.006	HOMA-β	0.311**	<0.001
OSI	0.151*	0.022	Insulin	0.383**	<0.001
Lymphocyte correlations with			Glucose	0.231**	<0.001
Insulin	−0.136*	0.039	WBC	0.312**	<0.001
WBC	0.399**	<0.001	Neutrophil	0.389**	<0.001
Neutrophil	−0.155*	0.019	NLR	0.323**	<0.001
NLR	−0.533**	<0.001	TAS	−0.142*	0.032
TOS	−0.157*	0.018	Total thiol	−0.157*	0.017
OSI	−0.170	0.01

WBC: White blood cell, NC: neutrophil count, LC: lymphocyte count, NLR: neutrophil/lymphocyte ratio, CRP: C-reactive protein, TAS: Total antioxidant status, TOS: Total oxidant status, OSI: Oxidative stress index.

BMI per: body mass index percentile, HOMA-IR: Homeostatic model of assistance of insulin resistance, HOMA-β: Homeostatic model assessment of β-cell function. Statistical analysis by Pearson's correlation. P < 0.05.

*Correlation is significant at the 0.05 level (2 tailed).

**Correlation is significant at the 0.01 level (2 tailed).

Table 5 The results of Pearson's correlation between oxidant/antioxidant status and other anthropometric and metabolic parameters

	r	P		r	P
TAS correlations with			TOS correlations with
HOMA-IR	−0.210**	0.001	Lymphocyte	−0.157**	0.018
HOMA-β	−0.169**	0.010	NLR	0.140*	0.034
Insulin	−0.215**	0.001	OSI	0.917**	<0.001
			OSI correlations with
CRP	−0.142*	0.032	HOMA-IR	0.157*	0.017
WBC	−0.145*	0.028	Insulin	0.154*	0.020
Neutrophil	−0.179**	0.006	Neutrophil	0.151*	0.022
NLR	−0.158*	0.016	Lymphocyte	−0.170*	0.010
Total thiol	0.163*	0.014	NLR	0.189*	0.004
OSI	−0.352**	<0.001	TAS	−0.352*	<0.001
Total thiol correlations with			TOS	0.917**	<0.001
CRP	−0.157*	0.017	Total thiol	−0.136*	0.040
TAS	0.163*	0.014
OSI	−0.136*	0.040

WBC: White blood cell, NC: neutrophil count, LC: lymphocyte count, NLR: neutrophil/lymphocyte ratio, CRP: C-reactive protein, TAS: Total antioxidant status, TOS: Total oxidant status, OSI: Oxidative stress index.

BMI per: body mass index percentile, HOMA-IR: Homeostatic model of assistance of insulin resistance. HOMA-β: Homeostatic model assessment of β-cell function. Statistical analysis by Pearson's correlation. P < 0.05

*Correlation is significant at the 0.05 level (2 tailed).

**Correlation is significant at the 0.01 level (2 tailed).