{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T07:06:25Z","timestamp":1784790385400,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: We compared biochemical, micronutrient-related and complete blood count (CBC)-derived inflammatory profiles among children with obesity, undernutrition and normal weight, and explored the discriminatory performance of selected routine laboratory markers for the obesity phenotype. Methods: In this single-centre retrospective comparative study, medical records of children aged 2\u201317 years evaluated between January 2023 and December 2025 were reviewed. Participants were classified as obese, undernourished or normal weight using World Health Organization (WHO) body mass index-for-age (BMI-for-age) references. Liver enzymes, lipid parameters, iron-related indices, micronutrient levels, zinc, insulin and CBC-derived inflammatory indices were compared across groups using non-parametric omnibus tests. Exploratory receiver operating characteristic (ROC) analyses were performed for selected markers. Results: A total of 690 children were included: 100 with obesity, 90 with undernutrition and 500 with normal weight. The obesity group was significantly older than the normal-weight group (median 11.0 vs. 7.5 years; p &lt; 0.001). Obesity was characterised by higher alanine aminotransferase (ALT), insulin, triglycerides, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), together with lower high-density lipoprotein (HDL) cholesterol, 25-hydroxyvitamin D [25(OH)D] and aspartate aminotransferase-to-alanine aminotransferase (AST\/ALT) ratio (all p &lt; 0.05). In exploratory, age-unadjusted ROC analyses, the AST\/ALT ratio yielded the highest AUC among the evaluated biomarkers (AUC 0.859; 95% CI 0.823\u20130.895; optimal cut-off \u2264 1.52; sensitivity 77.0%; specificity 77.6%), followed by SIRI (AUC 0.751; 95% CI 0.700\u20130.802). Conclusions: Pediatric obesity was associated with a distinct liver enzyme-metabolic-inflammatory laboratory profile, whereas undernutrition exhibited a different micronutrient-biochemical pattern. Because the study was retrospective and age-unadjusted, these findings should be interpreted as exploratory and hypothesis-generating. Prospective studies with age-balanced sampling, pubertal staging and liver imaging are required before clinical implementation.<\/jats:p>","DOI":"10.3390\/children13080975","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:11:42Z","timestamp":1784787102000},"page":"975","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biochemical and Inflammatory Profiles in Paediatric Obesity, Undernutrition and Normal Weight: A Single-Centre Retrospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2847-3941","authenticated-orcid":false,"given":"Taner","family":"Ad\u0131g\u00fczel","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Yalova University, 77200 Yalova, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erdin","family":"Kalyoncuo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, Yalova University, 77200 Yalova, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcls\u00fcm","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Medicine, Yalova University, 77200 Yalova, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2022060640","DOI":"10.1542\/peds.2022-060640","article-title":"Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity","volume":"151","author":"Hampl","year":"2023","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/S0140-6736(13)60937-X","article-title":"Maternal and child undernutrition and overweight in low-income and middle-income countries","volume":"382","author":"Black","year":"2013","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(19)32472-9","article-title":"The double burden of malnutrition: Aetiological pathways and consequences for health","volume":"395","author":"Wells","year":"2020","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1007\/s13679-021-00433-1","article-title":"Vitamin D and Obesity: Current Evidence and Controversies","volume":"10","author":"Karampela","year":"2021","journal-title":"Curr. Obes. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1111\/joim.13547","article-title":"Pediatric obesity\u2014Long-term consequences and effect of weight loss","volume":"292","author":"Marcus","year":"2022","journal-title":"J. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"347","DOI":"10.3345\/cep.2023.00892","article-title":"Metabolic complications of obesity in children and adolescents","volume":"67","author":"Park","year":"2024","journal-title":"Clin. Exp. Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1002\/jpn3.70177","article-title":"Liver function tests among children with moderate acute malnutrition: A secondary analysis of a randomised trial","volume":"81","author":"Winther","year":"2025","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e102994","DOI":"10.5812\/zjrms.102994","article-title":"The relationship between malnutrition and liver enzymes in hospitalised children in Zahedan: A case-control study","volume":"23","author":"Karajibani","year":"2021","journal-title":"Zahedan J. Res. Med. Sci."},{"key":"ref_9","first-page":"1546","article-title":"A new definition for metabolic dysfunction-associated steatotic liver disease: An international expert consensus statement","volume":"79","author":"Eslam","year":"2023","journal-title":"J. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/MPG.0000000000001482","article-title":"NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children","volume":"64","author":"Vos","year":"2017","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/S2468-1253(21)00183-7","article-title":"Defining paediatric metabolic (dysfunction)-associated fatty liver disease: An international expert consensus statement","volume":"6","author":"Eslam","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s12519-024-00814-1","article-title":"Prevalence of nonalcoholic fatty liver disease in paediatrics and adolescents: A systematic review and meta-analysis","volume":"20","author":"Lee","year":"2024","journal-title":"World J. Pediatr."},{"key":"ref_13","unstructured":"European Association for the Study of the Liver, European Association for the Study of Diabetes, and European Association for the Study of Obesity (2024). EASL\u2013EASD\u2013EASO clinical practice guidelines on the management of metabolic dysfunction-associated steatotic liver disease. J. Hepatol., 81, 492\u2013542."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jped.2020.08.006","article-title":"Vitamin D deficiency in children and adolescents with obesity: A meta-analysis","volume":"97","author":"Fiamenghi","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Ulloque-Badaracco, J.R., Alarcon-Braga, E.A., Hernandez-Bustamante, E.A., Von-Koeller-Jones, B.M., Huayta-Cortez, M., Saavedra-Custodio, E., Herrera-A\u00f1azco, P., and Benites-Zapata, V.A. (2025). Vitamin B12, folate, and homocysteine levels in children and adolescents with obesity: A systematic review and meta-analysis. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1481002"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Luo, L., Chen, L., Song, J., Ma, X., and Wang, X. (2024). Association between systemic immune-inflammatory index and systemic inflammatory response index with body mass index in children and adolescents: A population-based study (NHANES 2017\u20132020). Front. Endocrinol., 15.","DOI":"10.3389\/fendo.2024.1426404"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Marra, A., Bondesan, A., Caroli, D., and Sartorio, A. (2024). Complete blood count-derived inflammation indexes are useful in predicting metabolic syndrome in children and adolescents with severe obesity. J. Clin. Med., 13.","DOI":"10.3390\/jcm13072120"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1007\/s11596-024-2919-6","article-title":"Monocyte to high-density lipoprotein cholesterol ratio as a predictor of nonalcoholic fatty liver disease in childhood obesity","volume":"44","author":"Zhang","year":"2024","journal-title":"Curr. Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"von Elm, E., Altman, D.G., Egger, M., Pocock, S.J., G\u00f8tzsche, P.C., and Vandenbroucke, J.P. (2007). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040296"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"WHO Multicentre Growth Reference Study Group (2006). WHO child growth standards: Length\/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age. Acta Paediatr. Suppl., 450, 76\u201385.","DOI":"10.1111\/j.1651-2227.2006.tb02378.x"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"660","DOI":"10.2471\/BLT.07.043497","article-title":"Development of a WHO growth reference for school-aged children and adolescents","volume":"85","author":"Onyango","year":"2007","journal-title":"Bull. World Health Organ."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1053\/j.gastro.2009.12.052","article-title":"SAFETY study: Alanine aminotransferase cutoff values are set too high for reliable detection of paediatric chronic liver disease","volume":"138","author":"Schwimmer","year":"2010","journal-title":"Gastroenterology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1210\/jc.2015-2175","article-title":"Global consensus recommendations on prevention and management of nutritional rickets","volume":"101","author":"Munns","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/975\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:27:24Z","timestamp":1784788044000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/13\/8\/975"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,23]]},"references-count":23,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["children13080975"],"URL":"https:\/\/doi.org\/10.3390\/children13080975","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,23]]}}}