The association between clinical obesity and C-reactive protein levels: an analytical cross-sectional study in a Peruvian population.

Abstract

Introduction: The recent Lancet Diabetes & Endocrinology Commission framework distinguishes preclinical from clinical obesity according to the presence of obesity-related dysfunction. Objective: This study evaluated the association between these obesity categories and C-reactive protein (CRP) levels in a Peruvian population. Materials and Methods: Analytical cross-sectional study using baseline data (2007–2008) from the PERU MIGRANT study. Obesity was classified as no obesity, preclinical obesity, or clinical obesity using the Lancet framework. Excess adiposity was defined using Lancet Commission and Peruvian National Institute of Health (NIH) anthropometric cut-offs. Generalized linear models with gamma distribution and log link estimated mean ratios (MR) and 95% confidence intervals (CI). Sensitivity analyses used a stricter CRP threshold (≤10 mg/L). Results: Nine hundred fifty-three participants were included (mean age 47.7 years; 53.2% female). Using Lancet Commission anthropometric cut-offs, 16.1% and 12.2% were classified as having preclinical and clinical obesity, respectively; using Peruvian NIH cut-offs, the corresponding proportions were 30.0% and 17.3%. In adjusted models, preclinical obesity was associated with higher CRP (Lancet: MR 1.34; 95% CI: 1.08–1.75; Peruvian NIH: MR 1.25; 95% CI: 1.01–1.56), whereas clinical obesity showed stronger associations (Lancet: MR 1.76; 95% CI: 1.35–2.33; Peruvian NIH: MR 1.55; 95% CI: 1.20–2.02). Sensitivity analyses yielded consistent results. Conclusions: Both preclinical and clinical obesity were associated with higher CRP levels, with stronger associations for clinical obesity. These findings support the clinical relevance of the Lancet Commission framework and suggest that it captures meaningful differences in systemic inflammation across obesity categories.