Abstract
Cardiometabolic risk accrues across the life course and childhood and adolescence are key periods for effective prevention. Obesity is associated with inflammation in adults, but pediatric data are scarce. In a cross-sectional and longitudinal study, we investigated immune cell composition and activation in 31 adolescents with obesity (41.9% male, BMIz>2.5, 14.4 years) and 22 controls with healthy weight (45.1% male, -1.5<BMIz<1.5, 14 years). In those with obesity, we assessed the impact of weight change and correlations between immune profiles and subclinical cardiovascular phenotypes at a 5-year follow-up. Compared to controls, those with obesity had increased monocyte activation and cytokine production upon stimulation. Monocyte transcriptomics demonstrated upregulated inflammatory pathways and downregulated antiviral responses. Weight change was not associated with changes in inflammation. Baseline inflammation correlated with cardiovascular measures at follow-up. Children with obesity have increased inflammation, which associates with worse subsequent subclinical cardiovascular measures. Adjunctive anti-inflammatory interventions may be needed to reverse adverse subclinical cardiovascular phenotypes.