Adipokines Profile and Inflammation Biomarkers in Prepubertal Population with Obesity and Healthy Metabolic State.

Abstract

Background and aims: Obesity and high body max index (BMI) have been linked to elevated levels of inflammation serum markers such as C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), adiponectin, and resistin. It has been described that adipose tissue presents a high production and secretion of these diverse pro-inflammatory molecules, which may have local effects on the physiology of the fat cell and also systemic effects on other organs. Our aim was to evaluate the impact that lifestyle modifications, following a Mediterranean Diet (MedDiet) program and physical activity (PA) training, would have on inflammatory biomarkers in a metabolically healthy prepubertal population with obesity (MHOPp) from Malaga (Andalusia, Spain). (2) Methods: 144 MHOPp subjects (aged 5-9 years) were included in this study as they met ≤1 of the following criteria: waist circumference and blood pressure ≥ 90 percentile, triglycerides > 90 mg/dL, high-density lipoprotein cholesterol (HDL-c) 90 mg/dL, high-density lipoprotein cholesterol (HDL-c)< 40 mg/dL, or impaired fasting glucose (≥100 md/dL). Selected subjects followed a personalized intensive lifestyle modification. Anthropometric measurements, inflammation biomarkers, and adipokine profile were analyzed after 12 and 24 months of intervention. Results: 144 MHOPp participants (75 boys—52% and 69 girls—48%; p = 0.62), with an age of 7.8 ± 1.4 years and a BMI of 24.6 ± 3.3 kg/m2, were included in the study. After 24 months of intervention with MedDiet and daily physical activity, a significant decrease in body weight (−0.5 ± 0.2 SD units; p < 0.0001) and BMI (−0.7 ± 0.2 SD units; p < 0.0001) was observed in the total population compared to baseline. Serum inflammatory biomarkers (IL-6, TNF-alpha, and CRP) were significantly reduced after 24 months of intervention. The adipokine profile (adiponectin and resistin) did not improve with the intervention, as adiponectin levels significantly decreased and resistin levels increased in the entire population. Inflammatory biomarkers and the adipokine profile had a significant correlation with anthropometric parameters, body composition, and physical activity. Conclusions: After 24 months of lifestyle modification, our MHOPp participants reduced their BMI Z-score, leading to an improvement in inflammatory biomarkers but causing deterioration in the adipokine profile, which does not improve with the MedDiet and physical activity intervention. Adequate family education about healthier habits is necessary to prevent and reduce excessive obesity increase in childhood.