{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T21:47:26Z","timestamp":1792187246133,"version":"4.4.0"},"reference-count":34,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["75N94022F00050"],"award-info":[{"award-number":["75N94022F00050"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2024,7,17]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>Cross-sectional analyses were conducted among 2693 adolescents aged 12\u201319 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%\u2009CI) were calculated from logistic regression models to determine the association between CVD risk factors (obesity, overweight, dysglycemia, hypertension, hyperlipidemia) and elevated hs-CRP (&gt;3.0\u2009mg\/L) while controlling for sociodemographic characteristics and other CVD risk factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, 15.3% of adolescents had elevated hs-CRP. Adolescents who were older (16\u201319 years vs 12\u201315 years), obese, had A1c \u22655.7% (\u226539\u2009mmol\/mol), high total cholesterol, or low high-density lipoprotein had hs-CRP distributions that were more high risk (\u03c7<jats:sup>2<\/jats:sup> p value &lt;0.001). Adolescents with obesity or A1c \u22655.7% had a sixfold and a nearly twofold higher odds of elevated hs-CRP compared those without obesity and A1c &lt;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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2024-004148","type":"journal-article","created":{"date-parts":[[2024,8,3]],"date-time":"2024-08-03T12:55:11Z","timestamp":1722689711000},"page":"e004148","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Cardiovascular disease risk factors and their associations with inflammation among US adolescents: NHANES, 2015 to March 2020"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6293-383X","authenticated-orcid":false,"given":"Sarah S","family":"Casagrande","sequence":"first","affiliation":[{"name":"DLH Holdings Corporation, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2480-8480","authenticated-orcid":false,"given":"Jean M","family":"Lawrence","sequence":"additional","affiliation":[{"name":"NIDDK Division of Diabetes Endocrinology and Metabolic Diseases, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,3]]},"reference":[{"key":"2025073112422114000_12.4.e004148.1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000122867.89751.59"},{"key":"2025073112422114000_12.4.e004148.2","article-title":"Obesity: a chronic low-grade inflammation and its markers","volume":"14","author":"Khanna","year":"2022","journal-title":"Cureus"},{"key":"2025073112422114000_12.4.e004148.3","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3405","article-title":"An increase in inflammation and islet dysfunction is a feature of prediabetes","volume":"37","author":"Weaver","year":"2021","journal-title":"Diabetes Metab Res"},{"key":"2025073112422114000_12.4.e004148.4","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2016.58928"},{"key":"2025073112422114000_12.4.e004148.5","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20070657"},{"key":"2025073112422114000_12.4.e004148.6","doi-asserted-by":"crossref","DOI":"10.3390\/nu10050604","article-title":"Inflammation, not cholesterol, is a cause of chronic disease","volume":"10","author":"Tsoupras","year":"2018","journal-title":"Nutrients"},{"key":"2025073112422114000_12.4.e004148.7","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/S2213-8587(23)00025-6","article-title":"Trends in incidence of youth-onset type 1 and type 2 diabetes in the USA, 2002-18: results from the population-based SEARCH for diabetes in youth study","volume":"11","author":"Wagenknecht","year":"2023","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025073112422114000_12.4.e004148.8","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1001\/jamapediatrics.2022.2052","article-title":"Trends in obesity prevalence among children and adolescents aged 2 to 19 years in the US from 2011 to 2020","volume":"176","author":"Hu","year":"2022","journal-title":"JAMA Pediatr"},{"key":"2025073112422114000_12.4.e004148.9","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1001\/jamapediatrics.2022.0077","article-title":"Trends in prediabetes among youths in the US from 1999 through 2018","volume":"176","author":"Liu","year":"2022","journal-title":"JAMA Pediatr"},{"key":"2025073112422114000_12.4.e004148.10","doi-asserted-by":"crossref","unstructured":"Casagrande SS , Menke A , Linder B , et al . Cardiovascular risk factors in adolescents with prediabetes. Diabet Med 2018. doi:10.1111\/dme.13661","DOI":"10.1111\/dme.13661"},{"key":"2025073112422114000_12.4.e004148.11","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines11112961","article-title":"C-reactive protein as a marker of inflammation in children and adolescents with metabolic syndrome: a systematic review and meta-analysis","volume":"11","author":"Podeanu","year":"2023","journal-title":"Biomedicines"},{"key":"2025073112422114000_12.4.e004148.12","unstructured":"Centers for disease control and prevention (CDC) . National health and nutrition examination survey examination protocol. In: National center for health statistics (NCHS). Hyattsville, MD: U.S Department of Health and Human Services, 2015-2020."},{"key":"2025073112422114000_12.4.e004148.13","unstructured":"Centers for disease control and prevention (CDC) . National health and nutrition examination survey laboratory protocol. 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