{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:12:07Z","timestamp":1787170327855,"version":"build-2736575974"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic low-grade inflammation (metaflammation) is a central feature of obesity and contributes to metabolic complications. Complete blood count (CBC)\u2013derived inflammatory indices have been proposed as accessible markers of obesity-related inflammation, but their biological meaning in pediatric obesity remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether CBC-derived composite inflammatory indices primarily reflect adiposity-related inflammation or metabolic impairment in children with different obesity severities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cross-sectional study included 417 children aged 5\u201318 years, categorized into four groups according to body mass index (BMI) percentiles: normal weight, overweight, obese, and morbidly obese. The CBC-derived inflammatory indices, including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), aggregate inflammation index (AISI), and monocyte-to-high-density lipoprotein cholesterol ratio (MHR), were calculated. Insulin resistance was assessed using the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Trend, correlation analyses were performed. Multivariate linear regression models based on a predefined clinical rationale were created, and their discriminative performances were evaluated using ROC analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>SII, SIRI, AISI, and MHR levels increased as the severity of obesity increased, and a significant difference was observed, especially between the normal weight and morbidly obese groups. In multivariate models, the significant relationship between BMI-SDS and SII, AISI, and MHR persisted, whereas no relationship was found with SIRI. HOMA-IR was only associated with MHR. In ROC analyses, the ability of the inflammatory indices to distinguish between morbid obesity and insulin resistance was found to be limited (AUC approximately 0.55\u20130.68).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CBC-derived inflammatory indices in pediatric obesity appear to primarily reflect adiposity-related inflammatory burden rather than isolated insulin resistance. However, owing to their limited explanatory power and low discriminative performance, they should not be interpreted as standalone diagnostic tools but as biomarkers supporting clinical assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1778022","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T05:35:34Z","timestamp":1773207334000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of novel inflammatory biomarkers in overweight, obese, and morbidly obese children: a cross-sectional study"],"prefix":"10.3389","volume":"17","author":[{"given":"Semra Bahar","family":"Akin","sequence":"first","affiliation":[{"name":"Health Sciences University Derince Training and Research Hospital, Department of Pediatrics, Division of Pediatric Endocrinology","place":["Derince, Kocaeli, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha Yasin","family":"Akin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Immunology, Faculty of Medicine, Kocaeli University","place":["Kocaeli, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-023-00954-5","article-title":"Spatial\u2013temporal trends in global childhood overweight and obesity from 1975 to 2030: a weight mean center and projection analysis of 191 countries","volume":"19","author":"Gao","year":"2023","journal-title":"Global Health"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s42255-020-0183-z","article-title":"Childhood obesity and the associated rise in cardiometabolic complications","volume":"2","author":"Caprio","year":"2020","journal-title":"Nat Metab"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.639548","article-title":"Non-alcoholic fatty liver disease in obese youth with insulin resistance and type 2 diabetes","volume":"12","author":"Scapaticci","year":"2021","journal-title":"Front Endocrinol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2005.04.009","article-title":"The metabolic consequences of childhood obesity","volume":"19","author":"Weiss","year":"2005","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/oby.21945","article-title":"Association between peripheral adipokines and inflammation markers: A systematic review and meta-analysis","volume":"25","author":"Gra\u00dfmann","year":"2017","journal-title":"Obesity."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665112000092","article-title":"Obesity, inflammation and the immune system","volume":"71","author":"De Heredia","year":"2012","journal-title":"Proc Nutr Soc"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.adf9382","article-title":"Metaflammation in obesity and its therapeutic targeting","volume":"15","author":"Schleh","year":"2023","journal-title":"Sci Transl Med"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/nature05485","article-title":"Inflammation and metabolic disorders","volume":"444","author":"Hotamisligil","year":"2006","journal-title":"Nature."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2961","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":"B10","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-031210-101322","article-title":"Inflammatory mechanisms in obesity","volume":"29","author":"Gregor","year":"2011","journal-title":"Annu Rev Immunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00241","article-title":"Early inflammatory status related to pediatric obesity","volume":"7","author":"M\u0103rginean","year":"2019","journal-title":"Front Pediatr"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2021.811081","article-title":"Leukocytes and neutrophil\u2013lymphocyte ratio as indicators of insulin resistance in overweight\/obese school-children","volume":"8","author":"Rodr\u00edguez-Rodr\u00edguez","year":"2022","journal-title":". 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