Marra Alice, Bondesan Adele, Caroli Diana, Sartorio Alessandro
Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), 28824 Verbania, Italy.
Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), 20145 Milan, Italy.
J Clin Med. 2024 Apr 5;13(7):2120. doi: 10.3390/jcm13072120.
Childhood obesity is a globally increasing pathological condition leading to long-term health issues such as cardiovascular diseases and metabolic syndrome (MetS). This study aimed to determine the clinical value of the Complete Blood Count-derived inflammation indexes Monocyte/HDL-C ratio (MHR), Lymphocyte/HDL-C ratio (LHR), Neutrophil/HDL-C ratio (NHR), and System Inflammation Response Index (SIRI) to predict the presence of metabolic syndrome and its association with cardiovascular risk markers (HOMA-IR, TG/HDL-C, and non-HDL-C) in children and adolescents with obesity. The study included a total of 552 children/adolescents with severe obesity (BMI: 36.4 [32.7-40.7] kg/m; 219 males, 333 females; age: 14.8 [12.9-16.3] years), who were further subdivided based on the presence or absence of metabolic syndrome (MetS+ and MetS respectively). The MHR, LHR, and NHR indexes ( < 0.0001), but not SIRI ( = 0.524), were significantly higher in the MetS+ compared to the MetS- subgroup, showing a positive correlation with the degree of MetS severity ( < 0.0001). Furthermore, MHR, LHR, and NHR were positively associated with cardiometabolic risk biomarkers (HOMA-IR: MHR = 0.000, LHR = 0.001, NHR < 0.0001; TG/HDL-C: MHR, LHR, NHR < 0.000; non-HDL-C: MHR, LHR < 0.0001, NHR = 0.000). Finally, the ROC curve analysis demonstrated that among the analyzed indexes, only MHR, LHR, and NHR had diagnostic value in distinguishing MetS patients among children and adolescents with obesity (MHR: AUC = 0.7045; LHR: AUC = 0.7205; NHR: AUC = 0.6934; < 0.0001). In conclusion, the MHR, LHR, and NHR indexes, but not the SIRI index, can be considered useful tools for pediatricians to assess the risk of MetS and cardiometabolic diseases in children and adolescents with obesity and to develop multidisciplinary intervention strategies to counteract the widespread disease.
儿童肥胖是一种在全球范围内日益增多的病理状况，会导致诸如心血管疾病和代谢综合征（MetS）等长期健康问题。本研究旨在确定全血细胞计数衍生的炎症指标单核细胞/高密度脂蛋白胆固醇比值（MHR）、淋巴细胞/高密度脂蛋白胆固醇比值（LHR）、中性粒细胞/高密度脂蛋白胆固醇比值（NHR）和全身炎症反应指数（SIRI）对预测肥胖儿童和青少年代谢综合征的存在及其与心血管风险标志物（胰岛素抵抗指数、甘油三酯/高密度脂蛋白胆固醇和非高密度脂蛋白胆固醇）的关联的临床价值。该研究共纳入了552名重度肥胖儿童/青少年（体重指数：36.4[32.7 - 40.7]kg/m²；男性219名，女性333名；年龄：14.8[12.9 - 16.3]岁），并根据是否存在代谢综合征（分别为MetS+和MetS-）进一步细分。与MetS-亚组相比，MetS+亚组的MHR、LHR和NHR指数（<0.0001）显著更高，但SIRI指数（=0.524）并非如此，且与MetS严重程度呈正相关（<0.0001）。此外，MHR、LHR和NHR与心脏代谢风险生物标志物呈正相关（胰岛素抵抗指数：MHR = 0.000，LHR = 0.001，NHR < 0.0001；甘油三酯/高密度脂蛋白胆固醇：MHR、LHR、NHR < 0.000；非高密度脂蛋白胆固醇：MHR、LHR < 0.0001，NHR = 0.000）。最后，ROC曲线分析表明，在所分析的指标中，只有MHR、LHR和NHR在区分肥胖儿童和青少年中的MetS患者方面具有诊断价值（MHR：曲线下面积 = 0.7045；LHR：曲线下面积 = 0.7205；NHR：曲线下面积 = 0.6934；<0.0001）。总之，MHR、LHR和NHR指数而非SIRI指数，可被视为儿科医生评估肥胖儿童和青少年患MetS及心脏代谢疾病风险以及制定多学科干预策略以应对这种广泛疾病的有用工具。
