DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20210645

Association of high-sensitivity C-reactive protein level with central obesity of the children in a tertiary care hospital of Bangladesh

Dhiraj Chandra Biswas, Moshiur Rahman, Farzana Sharmin, Ismat Jahan, Ananya Roy, Suraiya Begum

Abstract


Background: Obesity is an exaggeration of normal adiposity. Central obesity in children has increased than general adiposity now a days, which is not routinely measured in clinical practice. Adipose tissue contributes to the secretion of a number of inflammatory cytokines which stimulate the production of high-sensitive C-reactive protein (hs–CRP) by the liver. The study was done to see the association of hs-CRP level with central obesity in Bangladeshi children.

Methods: A total of 110 obese children aged between 10 to 18 years with BMI≥95th centile and age and sex matched 55 non-obese children with BMI≥5th to <85th centile according to centers for disease control and prevention (CDC) growth chart were selected. A structured questionnaire was prepared taking into account demographic and clinical parameters. The hs-CRP were estimated in study subjects and then correlated to central obesity by waist height ratio (WHtR).

Results: The prevalence central obesity was 45.5% by WHtR and raised hs-CRP levels was 46.4% in obese children. About 62% of obese children had central obesity who had raised hs-CRP level ≥2 mg/l (high risk), which showed significant positive correlation with WHtR and was significantly raised in obese children.

Conclusions: A high proportion of central obesity was observed in obese children who had raised hs-CRP level, suggesting that it might be useful to assess future metabolic and cardiovascular complication.


Keywords


Central obesity, Physical activity, High-sensitive C-reactive protein, Body mass index

Full Text:

PDF

References


Kelishadi R, Mirmoghtadaee P, Najafi H, Keikha M. Systematic review on the association of abdominal obesity in children and adolescents with cardio-metabolic risk factors. J res med sci. 2015;20(3):294-307.

Savva SC, Tornaritis M, Savva ME, Kourides Y, Panagi A, Silikiotou N et.al. Waist circumference and waist-to-height ratio are better predictors of cardiovascular disease risk factors in children than body mass index. Int J Obesity. 2000;24(11):1453-8.

Namburi RP, Ponnala AR, Karthik TS, Rani PR, Maheshwari R. A study on metabolic variables and its association with high sensitive C-reactive protein in obese children and adolescents. Indian J Endocrinol Metab. 2013;17(1):S360-62.

Zhang C, Rexrode KM, Van Dam RM, Li TY, Hu F. Abdominal obesity and the risk of all-cause cardiovascular, and cancer mortality: sixteen year of follow up in US women. Circulation. 2008;117(13):1658-67.

Lindsay RS, Hanson RL, Roumain J, Ravussin E, Knowler WC, Tataranni PA. Body mass index as a measure of adiposity in children and adolescents: relationship to adiposity by dual energy x-ray absorptiometry and to cardiovascular risk factors. J Clin Endocrinol Metab. 2001;86(9):4061-7.

Neovius M, Rasmussen F. Evaluation of BMI based classification of adolescent overweight and obesity: Choice of percentage body fat cutoffs exerts a large influence. The COMPASS studies. Eur J Clin Nutri. 2008;62(10):1201 7.

Hall DM, Cole TJ. What use is the BMI? Archives of diseases in Childhood. 2006;91(4):283 6.

Nambiar S, Hughes I, Davies PS. Developing waist to height ratio cut offs to define overweight and obesity in children and adolescents. Public Health Nutri. 2010;13(10):1566 74.

Srinivasan SR, Wang R, Chen W, Wei CY, Xu J. Berenson GS. Utility of waist to height ratio in detecting central obesity and related adverse cardiovascular risk profile among normal weight younger adults (from the Bogalusa Heart Study). Am J Cardiol. 2009;104(5):721 4.

Roth CL, Kratz M, Ralston MM, Reinehr T. Changes in adipose-derived inflammatory cytokines and chemokines after successful lifestyle intervention in obese children. Metabolism. 2011;60(4):445-52.

Genest J. C-reactive protein: risk factor biomarker and/or therapeutic target? Canad J Cardiol. 2010;26:41A-4.

McCarthy HD, Ashwell M A. A study of central fatness using waist to height ratios in UK children and adolescents over two decades supports the simple message – ‘Keep your waist circumference to less than half your height’. Int J Obesity. 2006;30:988 92.

Kahn HS, Imperatore G, Cheng YJ. A population based comparison of BMI percentiles and waist to height ratio for identifying cardiovascular risk in youth. J Pediatr. 2005;146(4):482 8.

Hara M, Saitou E, Iwata F, Okada T, Harada K. Waist to height ratio is the best predictor of cardiovascular disease risk factors in Japanese schoolchildren. J Atheroscler Thrombosis. 2002;9(3):127 32.

Browning LM, Hsieh SD, Ashwell M. A systematic review of waist to height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0.5 could be a suitable global boundary value. Nutrition res reviews. 2010;23(2):247 69.

Sadanand CD, Anitha J, Raveesh PM. Relation between high sensitivity C reactive protein to obesity among Indians. Int J Med Sci Public Health. 2015;4(11):1523-6.

Mathieu P, Lemieux I, Després J. Obesity, inflammation, and cardiovascular risk. Clin Pharmacol Therap. 2010;87(4):407-16.

Consumer Food Service. Fast Food in South Africa, 2016. Available at http://www.euromonitor.com/fast-food-in-south-africa/report. Accessed 8 Dec 2020.

Quinterno A. Cause and Effect Premise: The Role of poverty, access to fast food restaurants, such as McDonald’s, and the Obesity Epidemic. Academia. 2016.

Abolfotouh MA, Sallam SA, Mohammed MS, Loutfy AA, Hasab AA. Prevalence of elevated blood pressure and association with obesity in egyptian school adolescents. Int J Hyperten. 2010;2011:1-8.

Rodrigues D, Padez C, Machado-rodrigues AM. Prevalence of Abdominal Obesity and Excess Weight among Portuguese Children and Why Abdominal Obesity Should Be Included in Clinical Practice. Acta Medica Portuguesa. 2018;31(3):159-64.

Zabeen B, Tayyeb S, Naz F, Ahmed F, Rahman M, Nahar J et al. Prevalence of obesity and central obesity among adolescent girls in a district school in Bangladesh. Indian J Endocrinol Metab. 2015;19(5):649-52.

Rafraf MA, Mohamadi EB, Gargari BP. Prevalence of overall and abdominal obesity among adolescent high school girls in Tabriz, Iran. Int Med J Malaysia. 2013;12:27‑32.

Regina F, Tirtamulia K, Warouw SM. Adiponectin and highly sensitive C-reactive protein levels in obese children aged 9 to 15 years. Paediatr Indonesia. 2011;51(1):7-11.

Soyoye D, Kolawole B, Ikem R, Enikuomehin A. Relationship between high-sensitivity C-reactive protein and anthropometric indices of obesity. Endocrine. 38:P235.

Brambilla P, Bedogni G, Moreno LA, Goran MI, Gutin B, Fox KR et.al. Cross validation of anthropometry against magnetic resonance imaging for the assessment of visceral and subcutaneous adipose tissue in children. Int j Obesity. 2006;30(1):23-30.

Owolabi EO, Ter Goon D, Adeniyi OV. Central obesity and normal-weight central obesity among adults attending healthcare facilities in Buffalo City Metropolitan Municipality, South Africa: a cross-sectional study. J Health Popul Nutr. 2017;36(1):54.

Yi KH, Hwang JS, Kim EY, Lee SH, Kim DH, Lim JS. Prevalence of insulin resistance and cardiometabolic risk in Korean children and adolescents: a population-based study. Diabetes research and clinical practice. 2014;103(1):106-13.

Shilpa BA, Jayashree SB, Amruta M, Mangesh T, Balaji NA. High-Sensitivity C-Reactive Protein: An Independent Proinflammatory Cardiac Marker in Healthy Overweight and Obese Individuals. J Res Obesity. 2014;1-8.

Pires A, Martins P, Pereira AM, Marinhoa J, Silvaa PV, Marques M et al. Pro-inflammatory triggers in childhood obesity: Correlation between leptin, adiponectin and high-sensitivity C-reactive protein in a group of obese Portuguese children. Rev Port Cardiol. 2014;33(11):691-7.

Cadenas-Sanchez C, Intemann T, Labayen I, Artero EG, Alvarez-Bueno C, Sanchis-Moysi J et al. On behalf of the PREFIT project group, Prevalence of severe/morbid obesity and other weight status and anthropometric reference standards in Spanish preschool children: The PREFIT project. Pediatr Res. 2019;87:501-10.

Paepegaeya AC, Gensera L, Bouillotd JL, Opperta JM, Clémenta K, Poitoua C. High levels of CRP in morbid obesity: the central role of adipose tissue and lessons for clinical practice before and after bariatric surgery. Surg Obesity Rel. 2014;11(1):148-54.

Dayal D, Jain H, Attri SV, Bharti B, Bhalla AK. Relationship of High Sensitivity C-Reactive Protein Levels to Anthropometric and other Metabolic Parameters in Indian Children with Simple Overweight and Obesity. J Clin Diagn Res. 2014;8(8):5-8.

Mirhoseini M, Daemi H, Babaiee MM, Asadi-Samani M, Mirhoseini L, Sedehi M. Serum concentration of hs-CRP in obese individuals with and without metabolic syndrome and its association with parameters of metabolic syndrome. J Renal Inj Prev. 2018;7(4):297-300.

Rehnuma B, Hassan Z, Ibrahim M, Ali L. Serum levels of high sensitivity C-Reactive protein and its association with lipidemic status in Bangladeshi healthy adults. J Pathol Nepal. 2014;4(8):644-8.

Bennett NR, Ferguson TS, Bennett FI, Tulloch-Reid MK, Younger-Coleman NMD, Jackson MD et al. High-sensitivity C-reactive protein is related to central obesity and the number of metabolic syndrome components in Jamaican young adults. Frontiers Cardiovascular Med. 2014;1(12).

Regina F, Tirtamulia K, Warouw SM. Adiponectin and highly sensitive C-reactive protein levels in obese children aged 9 to 15 years. Paediatr Indones. 2011;51(1):7-11.