Inflammation in metabolically healthy and metabolically abnormal adolescents: The HELENA study

Nutr Metab Cardiovasc Dis. 2018 Jan;28(1):77-83. doi: 10.1016/j.numecd.2017.10.004. Epub 2017 Oct 13.


Background and aims: Inflammation may influence the cardio-metabolic profile which relates with the risk of chronic diseases. This study aimed to assess the inflammatory status by metabolic health (MH)/body mass index (BMI) category and to assess how inflammatory markers can predict the cardio-metabolic profile in European adolescents, considering BMI.

Methods and results: A total of 659 adolescents (295 boys) from a cross-sectional European study were included. Adolescents were classified by metabolic health based on age- and sex-specific cut-off points for glucose, blood pressure, triglycerides, high density cholesterol and BMI. C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin (IL-6), complement factors (C3, C4) and cell adhesion molecules were assessed.

Results: Metabolically abnormal (MA) adolescents had higher values of C3 (p < 0.001) and C4 (p = 0.032) compared to those metabolically healthy (MHy). C3 concentrations significantly increased with the deterioration of the metabolic health and BMI (p < 0.001). Adolescents with higher values of CRP had higher probability of being in the overweight/obese-MH group than those allocated in other categories. Finally, high C3 and C4 concentrations increased the probability of having an unfavorable metabolic/BMI status.

Conclusions: Metabolic/BMI status and inflammatory biomarkers are associated, being the CRP, C3 and C4 the most related inflammatory markers with this condition. C3 and C4 were associated with the cardio-metabolic health consistently.

Keywords: Inflammation; Inflammatory biomarkers; Metabolic health; Metabolic syndrome; adolescents.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Biomarkers / blood
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Complement C3 / analysis
  • Complement C4 / analysis
  • Cross-Sectional Studies
  • Europe / epidemiology
  • Female
  • Health Status
  • Humans
  • Inflammation / blood*
  • Inflammation / diagnosis
  • Inflammation / epidemiology
  • Inflammation Mediators / blood*
  • Male
  • Metabolic Syndrome / blood*
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology
  • Pediatric Obesity / blood*
  • Pediatric Obesity / diagnosis
  • Pediatric Obesity / epidemiology
  • Prognosis
  • Risk Factors
  • Sex Factors


  • Biomarkers
  • C3 protein, human
  • Complement C3
  • Complement C4
  • Inflammation Mediators
  • C-Reactive Protein