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Obesity in adolescents keep going increase every year at various parts of the world, with no looking at social, economic, educational and cultural status. Obesity is combined from various mutual determination that integrated in cause accumulation excess body fat. Bad diet, lack activity physique, style life sedentary is contributor important in incident obesity in children and adolescents [1]. There are several mutual factors that contribute to obesity incident, among others factor biological (genetic, immune system, using medicine, transportation system hormones, disorders of the brain and nerves, psychology disease and microbiota) as well factor environment social among them covers culture, advertising food and drink sweetened, work, social media, smoking, use drugs and high screen time and in the end all factor are influence intake food, production energy, metabolism and activity physique [2].

Obesity even said as the pandemic to be factor risk happening death around the world with estimation about 2 million people die related obesity every year [3]. Obesity is also challenge in field increasing health that together with enhancement prevalence diseases catastrophic [4]. Experienced adolescents and children with obesity have an impact bad period long to health they among others will experience trend for experience obesity in adult [5]. Known teenager with experiencing obesity have a disease cardiometabolic as 67%-86%, which consists of type 2 diabetes mellitus, hypertension, fatty liver disease and dyslipidemia, while adults experience consist of heart coronary disease, stroke, kidney failure and cancer [6]. Obesity confiscated the same financing big with incident war. Besides that, obesity cause academic decline ability children and adolescents, limits movement, both at school, at home and on the spot playing that is impact on desire injure self alone even kill self [7].

Globally in 2016 it was recorded there is more of 340 million experienced children and adolescents have an obesity ages 5-19 years [8]. World Obesity Federation forecast in 2025 figures that obesity in children and adolescents in the world increase 206 million and in 2030 it will be 254 million with some countries have level obesity children and youth highest namely China, India, the United States, Indonesia and Brazil with other developed countries [9]. Prevalence obesity children and youth in Korea in 2021 is 30.8% increase from year before and it is indication for serious problem health in Korea [10]. Temporary in the United States amount teenager aged 12-19 years who experienced obesity by 17% [11]. One of the countries with medium income like Mexico has number obesity in children (5-11 years) by 35.6% and adolescents (12-19 years) by 40% [12].

Obesity consists from two criteria that is Metabolically Healthy Obesity (MHO) and Metabolically Unhealthy Obesity (MUO). Children and youth with Metabolically Unhealthy Obesity (MUO) will experience 2 or more symptoms consist of blood pressure 130/85 mm Hg or more, rate triglycerides above 150 mg/dL, HDL levels <40 mg/dL and Blood Fasting Glucose (BFG) >126 mg/dL [13]. Experienced obesity since children or teenager will tend endure until mature, so matter this cause enhancement blood glucose and lipid profile being a trigger hypertension and hyperlipidemia, causing number pain and death tall [14]. Obesity cause cardiometabolic disease proved with exists reaction marked inflammation, with identified marker inflammation in blood [15]. This Systematic literature review’s aim is for identify connection inflammatory biomarkers with metabolically unhealthy obesity in adolescent.

This systematic literature review is written based on guidelines Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) for helps describe what was done, what was found, in case the review protocol and what is planned [16]. In matter this give explanation about linkages between metabolically unhealthy obesity with biomarkers inflammation consist of Adiponectin, TNF-α, CRP and hs -CRP, IL-6 and IL-8 in obese adolescent. The guide based on four step that is identification, screening, eligibility and data extraction to be explained in the sub-chapter below.

Identification

Relevant articles with tree problem were collected. Searching for article conducted in May 2023, via PubMed. Range time publication selected article that is between 2018 to 2023. Searching use related keywords with metabolically unhealthy obesity, biomarkers inflammation and obese adolescents.

Filtering article

Article about acquired obesity were selected based on it is relevance using range time (five years), in the form of article full text. From the PubMed data base, obtained article 358 articles. On filtering, deleted article with obesity in adults up to 204 articles. Filtering done with only choose article with title according to keywords that is metabolically unhealthy obesity so that 166 articles were found. Then filtering third with only choose article selected based on keywords inflammatory biomarkers so that obtained as many as 10 articles that will analyzing.

Criteria eligibility

Stage eligibility involve step selection article other, where still publication found form book, book chapter, proceedings as well as report deleted. This systematic literature review only using related articles with biomarkers inflammatory, metabolically unhealthy obesity and adolescents. Country of place or location study no become consider in this study.

Data extraction

Stage data extraction is performed with read text complete from articles that have collected. Articles that have through a number of stage selection then analyzed, relevant information with problem will extracting. Relevant information are covers title study, year, methods, and results. With thus, at this stage articles that go through a screening and selection process eligibility fully read and selected return if they in accordance with goals and problems in this study. Results obtained will reviewed by the relationship with inflammatory biomarkers, metabolically unhealthy obesity and adolescents. The groove PRISMA research can show in Figure 1.

Figure 1: Flow chart systematic reviews with PRISMA method.

Connection inflammatory biomarkers with metabolically unhealthy obesity in adolescents obesity

The results show in Table 1.

Table 1: Article relation between inflammatory biomarkers with metabolically unhealthy obesity in adolescents obesity.

Obesity in children and adolescents who do not quick handled can trigger various disease, causes decline quality alive and even can cause early death. Obesity with high risk more tends to be category Metabolically Unhealthy Obesity (MUO) than Metabolically Healthy Obesity (MHO). This is proven with discoveries biomarkers inflammatory in the MUO group higher than MHO and have significant relationship. Obesity is inflammation chronic degrees low. There are several biomarker inflammation found in the study literature this consists of 10 articles like a adiponectin, TNF-α, CRP and hs-CRP, IL-6 and IL-8 (Figure 2).

Figure 2: Pathways obesity until produce inflammatory biomarkers.

Adiponectin function in guard balance metabolic with method increase function network adipose (muscle and fat), increases insulin sensitivity so rate glucose blood awake, set internal fat metabolism body as well as function in response immunity and trade. Antiinflammatory properties adiponectin given vessel protection, heart, lungs and large intestine. Higher serum adiponectin levels had reported own effect protection to risk cardiovascular and associated with maintained insulin sensitivity in children with obesity. On this study found has happen decline rate adiponectin in blood in adolescents experiencing metabolic unhealthy obesity. There are five articles that prove that the MUO has significant relationship with decline rate adiponectin. Started with healthy eat pattern, then influential to abnormality metabolism resulting from the reduction rate adiponectin. Study Randomized Controlled Trial (RCT) proves people with vegetarian meals pattern have rate higher adiponectin than omnivore. Consumption saturated fatty acids can influence body fat metabolism, it is caused deposition of fat on the endothelium blood vessels in the end create plaque as beginning from inflammation blood vessels. Increasingly production of adiponectin through intake healthy food can avoid inflammation and healthy blood vessels. Adiponectin is also believed guard gut health with guard function intestinal absorption and transport, as well lower risk intestinal obstruction [17].

The cytokine detected in MOU children and adolescents is TNF-α (Tumor Necrosis Factor-Alpha) which is a results secretion macrophages, T cells, B cells and NK (Natural Killer) cells happen dysfunction muscle heart, infection lungs, syndrome metabolism, disorders rate glomerular filtration, rate sour tendon in high blood, low HDL levels and with IL-6 to be factor trigger left heart fail. Enlarged adipocytes is trigger filtration macrophages to location fat accumulation and cause TNF-α The cytokine detected in MOU children and adolescents is TNF-α (Tumor Necrosis Factor-Alpha) which is a results secretion macrophages, T cells, B cells and NK (Natural Killer) cells happen dysfunction muscle heart, infection lungs, syndrome metabolism, disorders rate glomerular filtration, rate sour tendon in high blood, low HDL levels and with IL-6 to be factor trigger fail heart left. Enlarged adipocytes is trigger filtration macrophages to location fat accumulation and cause secretion of TNF-α. High levels of TNF-α can cause shock septic. TNF-α is one cytokines that occur in inflammation obesity consequence. TNF-α plays a role in defense against such bacteria agents, viruses and fungi. Diet using technical deficit calorie and high intake fiber as well as vitamins have proven significant decrease in TNF-α. Guard intake and metabolism body still healthy will avoid somebody from risk disease cardiovascular like coronary heart disease, hypertension, fail kidney disease, insulin resistance, arthritis and others disease. TNF-α at most increases in adolescents with abdominal obesity. Mechanism of molecular TNF-α secretion in adolescent obesity is that TNF-α inhibits activity insulin receptors on organs target so that insulin does not reach it, temporarily it's the pancreas produce insulin and then happen insulin resistance. Following effect biological from TNF-α, like exert neutrophils and monocytes to location inflammation to get rid of Microbe, stimulate macrophages secrete chemokine as well as exertion leukocytes, stimulate hypothalamus to induce hot. TNF-α levels in high amount lower contractility muscle heart, decrease smooth muscle tone, decrease pressure blood until shock [18].

Obesity and aging being potentially cause enhancement biomarker inflammation, like increased CRP (C Reactive Protein) and hs-CRP (high sensitive-CRP). Study prove exists connection between MUO and height rate hs-CRP in obese patients. CRP is closely related with enhancement risk diabetes, hypertension and cardiovascular disease. CRP is protein molecules produced in inflammation acute phase, produced by an increased liver after 6-8 hours since the occurrence of a stimulus, which is its concentration reach peak on the day second until day third. Normal CRP level is <5 mg/L, in inflammation light can increased by 10-40 mg/L and in inflammation weight 40-200 mg/L (Figure 3).

Figure 3: CRP scheme in the inflammatory process.

Based on Figure 3, CRP is divided become mCRP (monomeric CRP) and pCRP (pentameric CRP), each of which works as antiinflammatory (pCRP) and pro-inflammatory (mCRP). CRP can stimulate secretion monocytes at the time happen inflammation causes change form thrombocyte so that cause thrombus, can activate IL-8 secretion which is also a causative cytokine disturbance function cell endothelium. Change CRP levels by day third is a predictor of mortality some disease. IL-6 is biomarkers that become level of indicator inflammation and damage to the endothelium blood vessels so that happen enhancement atherosclerotic. High levels of IL-6 will influence formation thrombus and cause high risk of cardiovascular disease like hypertension. IL-6 is produced by monocytes in tissues visceral adipose. IL-6 is cast main in inflammation, hematopoiesis and response immune. Circulation healthy individual has 1/3 the level of IL-6. IL-6 is produced will stimulate production of CD4, CD8, T cells and T lymphocytes in the inflammatory process. IL-8 is Cytokines are produced by macrophages (monocytes) and after neutrophils cells and tissues exposed to antigens. IL-8 also induces neutrophils and granulocytes so that migrate to location of infection. IL-8 also affects release histamine and respond to invading viruses breathing channel. Location of infection first of all will release histamine which causes vasodilation of blood vessels and encourage neutrophil migration to that area (Table 2) [19,20].

Table 2: Role of adipokines.

Obesity with Metabolically Unhealthy Obesity (MUO) status in children and adolescents is high risk for experience metabolic disease. This is be marked with enhancement adipokines, namely TNF-α, CRP, IL-6 and IL-8 as well decline adiponectin. Based on results from systematic this literature review obtained conclusion that there is connection between inflammatory biomarkers with MUO in adolescent obesity.

1. Burton ET, Smith WA (2020) . Nutrients 12: 1425.

   [] [] []

2. Camilleri M, Staiano A (2019) . Trends Endocrinal Metal 30: 724-734.

   [] [] []

3. Jia P, Luo M, Li Y, Zheng JS, Xiao Q, et al. (2021) . Obes Rev 22: e12944.

   [] [] []

4. Karri S, Sharma S, Hatware K, Patil K (2019) . Biomed Pharmacother 110: 224-238.

   [] [] []

5. Kim OY, Kim EM, Chung S (2020) Impacts of dietary macronutrient pattern on adolescent body composition and metabolic risk: Current and future health status-A narrative review. Nutrients. 12: 3722.

   []

6. Bendor CD, Bardugo A, Pinhas-Hamiel O, Afek A, Twig G (2020) . Cardiovasc Diabetol 19: 1-4.

   [] [] []

7. Beynon C (2023) Association between children living with obesity and mental health problems: A data analysis of the Welsh Health Survey, UK. BMC Public Health 23: 383.

   []

8. Khatri E, Baral K, Arjyal A, Yadav RK, Baral S (2023) Prevalence of and risk factors for overweight among adolescents of a sub-metropolitan city of Nepal. PloS One 18: e0270777.

   []

9. Jebeile H, Kelly AS, O'Malley G, Baur LA (2022) . Lancet Diabetes Endocrinol 10: 351-365.

   [] [] []

10. Kim Y, Son K, Kim J, Lee M, Park KH, et al. (2023) . Nutrients 15: 698.

    [] [] []

11. Muturi N, Kidd T, Daniels AM, Kattelmann KK, Khan T, et al. (2018) . J Adolesc 68: 242-251.

    [] [] []

12. Aceves-Martins M, Lopez-Cruz L, Garcia-Botello M, Gutierrez-Gomez YY, Moreno-Garcia CF (2022) . Nutr Rev 80: 544-560.

    [] [] []

13. Smith GI, Mittendorfer B, Klein (2019) J Clin Invest 129: 3978-3989.

    [] [] []

14. Yeste D, Clemente M, Campos A, Fabregas A, Mogas et al. (2021) . Anales de Pediatria 94: 68-74.

    [] [] []

15. Ruperez AI, Olza J, Gil-Campos M, Leis R, Bueno G et al. (2018) . Nutr Metab Cardiovasc Dis 28: 524-530.

    [] [] []

16. Sarkis-Onofre R, Catala-Lopez F, Aromataris E, Lockwood C (2021) . Syst Rev 10: 1-3.

    [] [] []

17. Lin A, Ali S, Arnold BF., Rahman MZ, Alauddin M, et al. (2020). Effects of water, sanitation, hand washing, and nutritional interventions on environmental enteric dysfunction in young children: A cluster-randomized, controlled trial in rural Bangladesh. Clin Infect Dis 70: 738-747.

    []

18. Rogawski McQuade ET, Platts-Mills JA, Gratz J, Zhang J, Moulton LH, et al. (2020) Impact of water quality, sanitation, hand washing, and nutritional interventions on enteric infections in rural Zimbabwe: The Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial. J Infect Dis. 221: 1379-1386.

    [] [] []

19. Campbell RK, Schulze KJ, Shaikh S, Raqib R, Wu LS, et al. (2018) . Br J Nutr 119: 407-414.

    [] [] []

20. Susantiningsih T, Mustofa S (2018) Expression of IL-6 and TNF-a in Obesity JK. Unila 2.