High-sensitivity C-reactive protein is a predictive factor of adiposity in children: results of the identification and prevention of dietary- and lifestyle-induced health effects in children and infants (IDEFICS) study

Annunziata Nappo, Licia Iacoviello, Arno Fraterman, Esther M Gonzalez-Gil, Charis Hadjigeorgiou, Staffan Marild, Denes Molnar, Luis A Moreno, Jenny Peplies, Isabel Sioen, Toomas Veidebaum, Alfonso Siani, Paola Russo, Annunziata Nappo, Licia Iacoviello, Arno Fraterman, Esther M Gonzalez-Gil, Charis Hadjigeorgiou, Staffan Marild, Denes Molnar, Luis A Moreno, Jenny Peplies, Isabel Sioen, Toomas Veidebaum, Alfonso Siani, Paola Russo

Abstract

Background: Whereas cross-sectional studies have shown that obesity is associated with increased C-reactive protein (CRP) levels in children, little is known about the impact of low-grade inflammation on body mass changes during growth.

Methods and results: We assessed cross-sectionally and longitudinally the association of high-sensitivity (hs)-CRP levels with overweight/obesity and related cardiometabolic risk factors in the Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and InfantS (IDEFICS) cohort. 16 224 children from 8 European countries (2 to 9 years) were recruited during the baseline survey (T0). After the exclusion of 7187 children because of missing hs-CRP measurements and 2421 because of drug use during the previous week, the analysis was performed on 6616 children (Boys=3347; Girls=3269; age=6.3 ± 1.7 years). Of them, 4110 were reexamined 2 years later (T1). Anthropometric variables, blood pressure, hs-CRP, blood lipids, glucose and insulin were measured. The population at T0 was divided into 3 categories, according to the baseline hs-CRP levels. Higher hs-CRP levels were associated with significantly higher prevalence of overweight/obesity, body mass index (BMI) z-score and central adiposity indices (P values all <0.0001), and with higher blood pressure and lower HDL-cholesterol levels. Over the 2-year follow-up, higher baseline hs-CRP levels were associated with a significant increase in BMI z-score (P<0.001) and significantly higher risk of incident overweight/obesity.

Conclusions: Higher hs-CRP levels are associated to higher body mass and overweight/obesity risk in a large population of European children. Children with higher baseline levels of hs-CRP had a greater increase in BMI z-score and central adiposity over time and were at higher risk of developing overweight/obesity during growth.

Keywords: C‐reactive protein; inflammation; pediatric obesity; population.

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