Relationship between severe obesity and gut inflammation in children: what's next?

Preliminary evidence suggests an association between obesity and gut inflammation.To evaluate the frequency of glucose abnormalities and their correlation with systemic and intestinal inflammation in severely obese children.Thirty-four children (25 males; median age 10.8 ± 3.4 yrs) with severe obesity (BMI >95\%) were screened for diabetes with oral glucose tolerance test (OGTT), systemic inflammation with C-reactive protein (CRP) and gut inflammation with rectal nitric oxide (NO) and faecal calprotectin.BMI ranged from 23 to 44 kg/m2, and BMI z-score between 2.08 e 4.93 (median 2.69 ± 0.53). Glucose abnormalities were documented in 71\% of patients: type 2 diabetes in 29\%, impaired fasting glucose (IFG) in 58\%, and impaired glucose tolerance (IGT) in 37.5\%. Thirty-one patients (91\%) were hyperinsulinemic. CRP was increased in 73.5\% with a correlation between BMI z-score and CRP (p 0.03). Faecal calprotectin was increased in 47\% patients (mean 77 ± 68), and in 50\% of children with abnormal glucose metabolism (mean 76 ± 68 μg/g), with a correlation with increasing BMI z-score. NO was pathological in 88\%, and in 87.5\% of glucose impairment (mean 6.8 ± 5 μM).In this study, the prevalence of glucose abnormalities in obese children is higher than in other series; furthermore, a correlation is present between markers of systemic and intestinal inflammation and glucose abnormalities.