ArticleJournal of health, population, and nutrition2025
Mediating role of inflammatory markers (NLR, PLR, SII, SIRI) in the association between 25(OH)D deficiency and obesity in children and adolescents.
Article in Journal of health, population, and nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- The vitamin D-cardiovascular nexus unraveling mechanistic promise and trial reality.Nutrition & metabolism · 2026Review
- Obesity, Metabolic Syndrome and MASLD in Children: Inflammation as the Missing Link-A Short Narrative Review.Life (Basel, Switzerland) · 2026Review
- Establishment of age-specific reference intervals for peripheral blood SII, NLR, PLR, and LMR in healthy children.BMC immunology · 2026Article
- The Natural History of Prediabetes and Cardiovascular Disease in the Pediatric Population.Biomedicines · 2026Review
- Evaluation of novel inflammatory biomarkers in overweight, obese, and morbidly obese children: a cross-sectional study.Frontiers in endocrinology · 2026Article
- Vitamin D status and Its association with haematological inflammatory indices and cardiometabolic risk profiles: a retrospective cross-sectional study.Frontiers in cardiovascular medicine · 2026Article
- Comprehensive Evaluation of Non-Standard Inflammatory and Metabolic Indices in Obesity: A Single-Center Retrospective Study.Healthcare (Basel, Switzerland) · 2025Article
- Systemic inflammation versus clinical demographics: patient age surpasses the platelet-to-lymphocyte ratio in differentiating secondary trigeminal neuralgia.Frontiers in aging neuroscience · 2025Article
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Abstract
backgroundThe association between vitamin D deficiency and obesity in children and adolescents has garnered significant attention; however, the underlying mechanisms remain unclear. It is hypothesized that the inflammatory response may mediate the relationship between vitamin D deficiency and obesity.
objectiveThis study aims to investigate the mediating roles of inflammatory markers-namely, the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammatory response index (SIRI)-in the association between 25(OH)D deficiency and obesity.
methodsThis study utilized data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES) and included a sample of children and adolescents aged 2 to 17 years. The analysis employed complex sampling design weights, with continuous variables expressed as weighted means and categorical variables as weighted percentages. Baseline characteristics were compared using chi-square tests and t-tests. Inflammatory markers were categorized into quartiles, while the 25(OH)D levels were classified into three groups: deficiency, insufficiency, and adequacy. Multivariate logistic regression was conducted to examine the association between 25(OH)D deficiency, inflammatory markers, and obesity. Additionally, the mediating effect of inflammatory markers on the relationship between 25(OH)D deficiency and obesity was investigated through mediation analysis.
resultsA total of 10,613 children and adolescents were included in the study, with 1,650 classified in the obesity group. The findings indicated a significant association between 25(OH)D deficiency and obesity risk (OR = 0.634, 95% CI: 0.440-0.915, p = 0.018). Inflammatory markers, specifically NLR, PLR, SII, and SIRI, partially mediated the relationship between 25(OH)D deficiency and obesity, with NLR and SII exhibiting the most substantial mediating effects (mediation ratios of 3.85% and 4.29%, respectively, p < 0.001). Mediation analysis revealed that the total effect (TE), direct effect (DE), and indirect effect (IE) were all negative, suggesting that an increase in 25(OH)D levels is associated with a reduced risk of obesity, with inflammatory markers serving as intermediaries in this process.
conclusionThis study demonstrates a significant association between 25(OH)D deficiency and obesity in children and adolescents, with inflammatory markers-particularly NLR and SII-playing a partial mediating role in this relationship. These findings indicate that 25(OH)D may influence the development of obesity by modulating the inflammatory response.
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