DLH Holdings Corporation, Atlanta, Georgia, USA
NIDDK Division of Diabetes Endocrinology and Metabolic Diseases, Bethesda, Maryland, USA.
BMJ Open Diabetes Res Care. 2024 Aug 3;12(4):e004148. doi: 10.1136/bmjdrc-2024-004148.
The prevalence of obesity and glycemic dysfunction in adolescents has increased over the past several decades but less is known on how these conditions are associated with systemic inflammation in this population. This study determined the associations between cardiovascular disease (CVD) risk factors and inflammation among a nationally representative sample of US. adolescents.
Cross-sectional analyses were conducted among 2693 adolescents aged 12-19 years who participated in the 2015 to March 2020 National Health and Nutrition Examination Surveys. Chronic inflammation was determined using laboratory measures for high-sensitivity C reactive protein (hs-CRP). Adjusted ORs (aOR, 95% CI) were calculated from logistic regression models to determine the association between CVD risk factors (obesity, overweight, dysglycemia, hypertension, hyperlipidemia) and elevated hs-CRP (>3.0 mg/L) while controlling for sociodemographic characteristics and other CVD risk factors.
Overall, 15.3% of adolescents had elevated hs-CRP. Adolescents who were older (16-19 years vs 12-15 years), obese, had A1c ≥5.7% (≥39 mmol/mol), high total cholesterol, or low high-density lipoprotein had hs-CRP distributions that were more high risk (χ p value <0.001). Adolescents with obesity or A1c ≥5.7% had a sixfold and a nearly twofold higher odds of elevated hs-CRP compared those without obesity and A1c <5.7% after full adjustment (aOR=6.39, 4.64 to 8.79 and aOR=1.70, 1.05 to 3.06, respectively). Adolescents with hypertension or hyperlipidemia were significantly more likely to have elevated hs-CRP compared with those without these conditions after adjustment for sociodemographic characteristics (aOR=2.46, 1.08 to 5.60 and aOR=2.19, 1.36 to 3.54, respectively), but the association was not significant after further adjustment for obesity.
Among US adolescents, obesity was strongly associated with elevated hs-CRP, a marker for future CVD risk. Given the obesity epidemic and the marked proportion with elevated CRP, concern should be given to future CVD risk in younger adults.
在过去几十年中，青少年肥胖和血糖功能障碍的患病率有所增加，但人们对这些情况如何与该人群的系统性炎症相关知之甚少。本研究旨在确定心血管疾病 (CVD) 风险因素与美国具有代表性的青少年人群炎症之间的关系。
对 2015 年至 2020 年 3 月参加全国健康和营养检查调查的 2693 名 12-19 岁青少年进行横断面分析。使用高敏 C 反应蛋白 (hs-CRP) 的实验室测量来确定慢性炎症。通过逻辑回归模型计算调整后的比值比 (aOR，95%置信区间)，以确定 CVD 风险因素 (肥胖、超重、血糖异常、高血压、血脂异常) 与 hs-CRP 升高 (>3.0mg/L) 之间的关联，同时控制社会人口统计学特征和其他 CVD 风险因素。
总体而言，15.3%的青少年 hs-CRP 升高。与 12-15 岁相比，16-19 岁、肥胖、A1c≥5.7% (≥39mmol/mol)、总胆固醇升高或高密度脂蛋白降低的青少年，hs-CRP 分布更具高危性 (χp值<0.001)。在充分调整后，与非肥胖和 A1c<5.7%的青少年相比，肥胖或 A1c≥5.7%的青少年 hs-CRP 升高的几率高 6 倍和近 2 倍(aOR=6.39，4.64 至 8.79 和 aOR=1.70，1.05 至 3.06)。与无高血压或高血脂的青少年相比，调整社会人口统计学特征后，高血压或高血脂的青少年 hs-CRP 升高的几率显著更高(aOR=2.46，1.08 至 5.60 和 aOR=2.19，1.36 至 3.54)，但在进一步调整肥胖后，这种关联不再显著。
在美国青少年中，肥胖与 hs-CRP 升高密切相关，hs-CRP 升高是未来 CVD 风险的标志物。鉴于肥胖流行和 CRP 升高的比例显著，应关注年轻成年人的未来 CVD 风险。
