Enhanced Myeloid Leukocytes in Obese Children and Adolescents at Risk for Metabolic Impairment

Abstract

Objective: We aimed to examine if myeloid leukocyte profiles are associated with metabolic impairment in children and adolescents with obesity, and if sex, age, or race influence this relationship. Methods: 282 children ages 8-17 were evaluated. Predictor measures were absolute neutrophil counts (ANC), absolute monocyte count, monocyte subtypes and C reactive protein (CRP). Outcome variables were waist circumference, fasting glucose and insulin, HOMA-IR, HbA1c (%) and lipid profiles. Pearson correlation coefficients were used to determine associations between predictor and outcome variables. Wilcoxon two-sample tests were used to evaluate differences by sex. Results: CRP (p < 0.0001), ANC (p < 0.0018), and classical monocytes (p = 0.05) were significantly higher in children with obesity. CRP, ANC and classical monocytes showed positive correlations with waist circumference, insulin, HOMA-IR and triglycerides. CRP was positively associated with ANC overall (p = 0.05). ANC demonstrated positive correlation with monocytes (p < 0.001). The associations between predictor and outcome variables were influenced by sex, race, and age. Conclusions: CRP and myeloid leukocyte populations, specifically classical monocytes and neutrophils associate with both body composition and metabolic parameters in children with obesity suggesting that these cells may play a critical role in metabolic impairment. Race, gender and age interactions between monocytes and metabolic parameters were significant.

Keywords: CRP; inflammation; insulin resistance; monocytes; pediatric obesity.

Figure 1

Flow cytometry gating scheme for monocyte evaluations.

Figure 2

Relationship of monocyte populations with waist circumference, HOMA-IR, and triglycerides (A) % CD14⁺⁺CD16⁻ (Classical monocytes), (B) % CD14⁺CD16⁺⁺ (Non-classical monocytes), and (C) % CD14⁺CD16⁺⁺ (Non-classical monocytes).

Figure 3

Association of inflammatory markers. Distribution of (A) absolute neutrophil counts (ANC) and CRP levels and (B–D) % CD14⁺⁺CD16⁻ (Classical monocytes) with ANC across weight categories.

Figure 4

Graphical display of effect of race/ethnicity and age interactions between predictor and metabolic outcome variables. Relationship between (A) fasting insulin and BMI, (B) fasting triglycerides and BMI Z-score, (C) classical monocytes and fasting insulin, (D) classical monocytes and fasting HD with race/ethnicity interactions. Relationship between (E) waist circumference with BMI Z-score, (F) HOMA-IR with BMI Z-score, (G) HbA1C(%) with intermediate monocytes, and (H) fasting HDL with intermediate monocytes with age interactions. *The “Other race” category includes: All participants who reported Asian and Hispanic race, and who reported more than one race.