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Licensed Unlicensed Requires Authentication Published by De Gruyter December 2, 2021

The association between a metabolically healthy overweight/obesity phenotype and markers of inflammation among Chinese children and adolescents aged 10–18 years

  • Jinyu Zhou ORCID logo , Ling Bai , Yangyang Dong , Rongrong Cai and Wenqing Ding EMAIL logo



The association between metabolically healthy overweight/obesity (MHO) and inflammatory markers remains controversial. The aim of the present study was to describe the prevalence of different metabolic phenotypes and to examine the relationship of different metabolic phenotypes with inflammatory markers among Chinese children and adolescents.


The study included 1,125 children and adolescents aged 10–18 years using a cross-sectional survey, and all subjects were classified into four groups based on a combination of BMI and metabolic status. In addition, the inflammatory markers we measured were high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6).


The prevalence of metabolically healthy with normal-weight (MHNW), MHO, metabolically unhealthy with normal-weight (MUNW), and metabolically unhealthy overweight/obesity (MUO) phenotypes was 38.76, 7.11, 38.67 and 15.47%, respectively. The results of logistic regression analysis showed that the MHO was associated with the z scores of hs-CRP in Chinese children and adolescents (OR=0.57, 95% CI: 0.39–0.83). Meanwhile, multivariate adjusted regression analysis showed that the relationship between hs-CRP and MHO among the overweight/obese was consistent with the results above, but among the normal-weight, only the highest quartile of TNF-α could increase the risk of MUNW (OR=1.65, 95% CI: 1.09–2.52).


MHO phenotypes were not common in Chinese children and adolescents. Individuals with MHO had a more beneficial hs-CRP profile than those with MUO.

Corresponding author: Wenqing Ding, PhD, Professor, Department of Children and Adolescents Health Care, School of Public Health, Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, No. 1160, Shengli Street, Xingqing District, Yinchuan, Ningxia, 750000, China, E-mail:

Award Identifier / Grant number: 82160641

  1. Research funding: Project supported by Ningxia Medical University scientific research project, and the National Science Foundation of China (Grant No. 82160641).

  2. Author contribution: ZJY, DYY, and DWQ designed, planned, and interpreted the study. BL and CRR collected the data and performed the statistical analysis. ZJY wrote the initial paper, and DWQ revised the paper and led the study. All authors read and approved the final manuscript. DWQ is the corresponding author to this paper.

  3. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication. The authors declare that there are no conflicts of interest regarding the publication of this paper.

  4. Ethics approval: This study was approved by the ethics committee of the Ningxia Medical University (approval number: 2021-G053). All the subjects agreed to participate in this study and provided written informed consent.


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Received: 2021-03-29
Accepted: 2021-11-15
Published Online: 2021-12-02
Published in Print: 2022-01-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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