Clinical Relevance of Transforming Growth Factor-β1, Interleukin-6 and Haptoglobin for Prediction of Obesity Complications in Prepubertal Egyptian Children


  • Inas R. El-Alameey National Research Centre, Child Health Department, Dokki, Cairo
  • Nevein N. Fadl National Research Centre, Medical Physiology Department, Dokki, Cairo
  • Enas R. Abdel Hameed National Research Centre, Child Health Department, Dokki, Cairo
  • Lobna S. Sherif National Research Centre, Hormones Department, Dokki, Cairo
  • Hanaa H. Ahmed National Research Centre, Child Health Department, Dokki, Cairo



Obesity Complications, Egyptian Children, Prepubertal, prediction, transforming growth factor-β1, interleukin-6, haptoglobin, clinical relevance


BACKGROUND: The rate of obesity is increasing throughout the world. Obesity in adults’ research is characterized by chronic inflammation, associated with type 2 Diabetes and cardiovascular risk. The degree to which these changes occur in childhood obesity is not fully defined.

AIM: This study was designed to explore the relation between circulating levels of pro-inflammatory cytokines, and obesity.

PATIENTS AND METHODS: This cross sectional case control study was carried out in 50 randomly selected pre-pubertal overweight and obese children compared with fifty apparently healthy children of matched age and sex. Serum levels of transforming growth factor-β1, interleukin-6, and haptoglobin were quantified by ELISA technique.

RESULTS: ANOVA test followed by Post Hoc test showed highly significant increase in the serum levels of the transforming growth factor-β1, interleukin-6 and haptoglobin among obese children compared to overweight and healthy children respectively. The body weight, BMI and BMI z-score were significantly positively correlated with serum levels of the three pro-inflammatory cytokines. Serum levels of interleukin-6, and haptoglobin were found to be strong predictors of complications in severe obesity by linear regression analysis.

CONCLUSIONS: Obesity is associated with chronic low-grade inflammation. High levels of interleukin-6 and haptoglobin are considered to be early biomarkers of inflammation associated with severe obesity with subsequent cardiovascular and type 2 diabetes risk.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Finucane MM, Stevens GA, Cowan MJ. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. The Lancet. 2011; 377 (9): 557–567.

Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity and trends in body mass index among US children and adolescents, 1999-2010. JAMA. 2012; 307(5):483-490.

Galcheva SV, Iotova VM, Yotov YT, Bernasconi S, Street ME. Circulating proinflammatory peptides related to abdominal adiposity and cardiometabolic risk factors in healthy prepubertal children. Eur J Endocrinol. 2011; 164 (4):553-558.

McMurray RG, Zaldivar F, Galassetti P. Cellular immunity and inflammatory mediator responses to intense exercise in overweight children and adolescents. J Investig Med. 2007; 55(3):120-129.

Wang Y, Kinzie E, Berger FG, Lim SK, Baumann H. Haptoglobin, an inflammation-inducible plasma protein. Redox Rep. 2001; 6:379-85.

Nielsen MJ, Moestrup SK. Receptor targeting of hemoglobin mediated by the haptoglobins: roles beyond heme scavenging. Blood. 2009; 114:764-71.

Yudkin JS, Kumari M, Humphries SE, Mohamed-Ali V. Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link? Atherosclerosis. 2000; 148: 209.

Tam CS, Garnett SP, Cowell CT. IL-6, IL-8 and IL-10 levels in healthy weight and overweight children. Horm Res Paediatr. 2010; 73(2):128-134.

Bastard JP, Maachi M, Tran Van Nhieu J, Jardel C, Bruckert E, Grimaldi A, Robert JJ, Capeau J, Hainque B. Adipose tissue IL-6 content correlates with resistance to insulin activation of glucose uptake both in vivo and in vitro. J Clin Endocrinol Metab. 2002; 87: 2084.

Sacheck J. Pediatric obesity: an inflammatory condition? Journal of Parenteral and Enteral Nutrition. 2008; 32(6):633–637.

Mohamed-Ali V, Goodrick S, Rawesh A, Katz DR, Miles JM, Yudkin JS, Klein S, Coppack SW. Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol Metab. 2007; 82: 4196.

Maffeis C, Silvagni D, Bonadonna R, Grezzani A, Banzato C, Tatò L. Fat cell size, insulin sensitivity, and inflammation in obese children. Journal of Pediatrics. 2007; 151(6):647–652.

Annes JP, Munger JS, and Rifkin DB. Making sense of latent TGF-β activation. Journal of Cell Science. 2003; 116(2):217–224.

Aihara K, Ikeda Y, Yagi S, Akaike M, Matsumoto T. Transforming Growth Factor-β1 as a Common Target Molecule for Development of Cardiovascular Diseases, Renal Insufficiency and Metabolic Syndrome. Cardio Res Pract. 2011; 175-183.

Leas KA. Potential therapeutic targets for cardiac fibrosis: TGF-β, angiotensin, endothelin, CCN2, and PDGF, partners in fibroblast activation. Circulation Research. 2010; 106:1675–1680.

Morrison JA, Friedman LA, Wang P, Glueck CJ. Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later. J Pediatr. 2008; 152(2):201-206.

Suthanthiran M, Gerber LM, Schwartz JE. Circulating transforming growth factor-β1 levels and the risk for kidney disease in African Americans. Kidney International. 2009; 76(1): 72–80.

Herder C, Schneitler S, Rathmann W. Low-grade inflammation, obesity, and insulin resistance in adolescents. J Clin Endocrinol Metab. 2007; 92(12):4569-4574.

Skinner AC, Steiner MJ, Henderson FW, Perrin EM. Multiple markers of inflammation and weight status: Cross-sectional analyses throughout childhood. Pediatrics. 2010; 125(4): 801-9.

Lohman, T.G., Roche A.F, Martorell R. Anthropometric standardization reference manual. Champaign, IL: Human kinetics Publishers, 1988.

Tanner JM, Hiernaux J, Jarman S, Weiner JS, Lourie JA. Growth, and physique studies. Human biology: A guidance to fields methods. Eds.Weiner JS, Lourie SA, IBP. London, Blackwell Scientific Publications. Oxford Blackwell Scientific Publications, 1969: 273-275.

WHO, Anthro Plus for personal computers. Manual Software for assessing growth of the world's children, and adolescents. Geneva, 2009. (

Bauer J, Herrmann F. Interleukin-6 in clinical medicine. Ann Hematol. 1991; 62: 203–210.

Kropf J, Schurek JO, Wollner A, Gressner AM. Immunological measurement of transforming growth factor-beta I (TGF-beta 1) in blood; assay development and comparison. Clinical Chemistry 1997; 43:1965-1974.

Van Vlierberghe H, Langlois M, Delanghe J. Haptoglobin polymorphisms and iron homeostasis in health and in disease. Clin Chim Acta. 2004; 345: 35-42

National Center for Health Statistics, Health, United States: The prevalence of obesity with special features on socioeconomic status and health. Hyattsville, MD; U.S, Department of Health and Human Services, 2014.

Hassan NE, EL-Ashry HH, Awad AH, El-Masry SA, Youssef MM, Sallam MM, Anwar M. Adiponectin in obese children and its association with blood pressure and anthropometric markers. Medical Research Journal. 2011; 10 (1): 1–4.

El Derwi D, El Sherbiny N, Atta AH. Exploring Fayoum (Upper Egypt) preparatory school students’ and teachers’ attitude towards obesity as health risk. J Public Health Epidemiol. 2011; 3: 401– 406.

Arslan N, Erdur B, Aydin A. Hormones and cytokines in childhood obesity. Indian Pediatr. 2010; 47(10):829-839.

Heriberto Rodríguez-Hernández, Luis E. Simental-Mendía, Gabriela Rodríguez-Ramírez, and Miguel A. Reyes- Romero: Obesity and Inflammation: Epidemiology, Risk Factors, and Markers of Inflammation. International Journal of Endocrinology. 2013;1-11.

Gregor MF, Hotamisligil GS. Inflammatory mechanisms in obesity. Annual Review of Immunology. 2011; 29:415–445.

Faloia E , Michetti G., de Robertis M., Luconi M P, Furlani G, Boscaro M. Inflammation as a link between obesity and metabolic syndrome, Journal of Nutrition and Metabolism. 2012;1-7. Article ID 476380.

Giannini C, de Giorgis T, Scarinci A, Ciampani M, Marcovecchio ML, Chiarelli F, Mohn A. Obese related effects of inflammatory markers and insulin resistance on increased carotid intima media thickness in pre-pubertal children. Atherosclerosis. 2008;197(1):448-56.

Steene J, Kolle E, Reseland JE, Anderssen SA, Andersen LB. Waist circumference is related to low-grade inflammation in youth. Int J Pediatr Obes. 2010; 5(4):313- 319.

Chiellini C, Santini F, Marsili A, Berti P, Bertacca A, Pelosini C. Serum haptoglobin: a novel marker of adiposity in humans. J Clin Endocrinol Metab. 2004; 89:2678-83.

Matthews VB, Allen TL, Risis S, Chan MH, Henstridge DC, Watson N. Interleukin-6-deficient mice develop hepatic inflammation and systemic insulin resistance. Diabetologia. 2010; 53:2431-41.

Fain JN, Tichansky DS, Madan AK: Transforming growth factor -β1 release by human adipose tissue is enhanced in obesity. Metabolism. 2005; 54: 1546-1551.

Romano M, Guagnano MT, Pacini G. Association of inflammation markers with impaired insulin sensitivity and coagulative activation in obese healthy women. J Clin Endocrinol Metab. 2003; 88: 5321-5326.

Kinik ST, Özbek N, Yüce M, Yazıcı AC, Verdi H, Ataç FB. PAI-1 gene 4G/5G polymorphism, cytokine levels and their relations with metabolic parameters in obese children. Thromb Haemost. 2008; 99: 352-356.

Kanra AR, Tulgar-Kinik S, Verdi H, Ataç FB, Yazici AC, Ozbek N. Transforming growth factor-beta1 (509 C/T, 915 G/C, 869 T/C) polymorphisms are not related to obesity in Turkish children. Turk J Pediatr. 2011; 53(6):645-50.

Stolzman S, Bement MH. Inflammatory Markers in Pediatric Obesity: Health and Physical Activity Implications. Infant, Child, & Adolescent Nutrition, 2012; 4(5): 297-302.

Yener S, Demir T, Akinci B. Transforming growth factor-beta 1 levels in women with prior history of gestational diabetes mellitus. Diabetes Res Clin Pract. 2007; 76: 193-198.

Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation. 2003; 107: 363.

Skinner AC, Steiner MJ, Henderson FW, Perrin EM. Multiple markers of inflammation and weight status: Cross-sectional analyses throughout childhood. Pediatrics. 2010; 125 (4): 801-9.



How to Cite

El-Alameey IR, Fadl NN, Abdel Hameed ER, Sherif LS, Ahmed HH. Clinical Relevance of Transforming Growth Factor-β1, Interleukin-6 and Haptoglobin for Prediction of Obesity Complications in Prepubertal Egyptian Children. Open Access Maced J Med Sci [Internet]. 2015 Jan. 22 [cited 2022 Aug. 14];3(1):105-10. Available from:



B - Clinical Sciences

Most read articles by the same author(s)

1 2 3 > >>