C-reactive protein and metabolic syndrome in obese and normal weight Hungarian children.

Introduction: It is well known that obese children frequently have high C- reactive protein (CRP) values. There are controversies about the association of the CRP and components of the metabolic syndrome (MetS). The aim of this study was to determine among children and adolescents the link between the most routinely used inflammation marker, CRP, and components of the MetS.

Methods: The study recruited 506 obese/overweight and 249 normal weight participants (ages 4-18 years) with complete fasting laboratory and anthropometric data. Statistical analyses, including multinomial logistic regression, were conducted in R, with significance set at p<0.05.

Results: Children were divided into three groups according to CRP concentration (low <1 mg/l, medium: 1-3 mg/l, high >3 mg/l). The children were also classified whether they had MetS (n =249) or were free of MetS (n = 421). We found highly significant difference between CRP groups in the occurrence of the MetS components (p < 0.001), hypertension (p < 0.001), hypertriglyceridemia (p < 0.001), and low high-density lipoprotein (HDL) cholesterol (p = 0.001), waist circumference (p < 0.001), body mass index(BMI) z-score (p < 0.001), fasting plasma glucose (p <0.001), homeostasis model assessment of insulin resistance (p <0.001) respectively. However, when BMI z-score was included in the model this relationship disappeared, suggesting that BMI has a more significant effect on the MetS components than CRP.

Conclusion: Our results demonstrate that BMI z-score is the main determinant of the MetS and its components. However, CRP remains an important factor to be checked in overweight and obese children.