Association between the dietary inflammatory index and spexin levels, metabolic syndrome, and inflammatory biomarkers in children with obesity.

Background: Chronic low-grade diet-related inflammation has been indicated to affect obesity and metabolic syndrome (MetS). The current study was designed to explore the Dietary Inflammatory Index (DII) in children and its relationship with spexin levels, appetite, and various cardiometabolic factors, including MetS, obesity, insulin resistance, and specific inflammatory biomarkers. Methods: This study included 90 obese adolescents and 90 normal-weight adolescents for overall analysis. A subset of 90 participants (45 obese and 45 normal-weight) provided blood samples for biochemical assays. Dietary intake was assessed using a validated 168-item semi-quantitative food frequency questionnaire, from which the DII score was calculated. Multivariable logistic regression models were employed to evaluate the association between the DII score and cardiometabolic risk factors. Results: The children's mean DII score was - 1.25 (± 1.01). Higher DII scores (indicating a more pro-inflammatory diet) were significantly associated with increased odds of obesity across all adjusted models (OR: 2.03, 95% CI: 1.10-3.75). A significant positive correlation was found between DII scores and high-sensitivity C-reactive protein levels (r = 0.30, P = 0.005). In crude analysis, the most anti-inflammatory diet was associated with higher spexin and interleukin-10 levels and a lower appetite score; however, these associations were no longer significant after adjustment for confounders. No significant associations were found between DII and metabolic syndrome or its components. Conclusion: These findings indicate that the influence of the DII on obesity may be primarily mediated through spexin levels, inflammatory markers, and appetite regulation, rather than through direct effects on MetS components.