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Diabetes, Cardiovascular Risks, and Lipoproteins / Adipokines, Inflammation, and Metabolic Diseases · Journal article
BMC Endocrine Disorders · September 7, 2026
Encouraging direction, but not yet definitive.
This cross-sectional study of 151 Nigerian adults with type 2 diabetes found that high-sensitivity C-reactive protein (hs-CRP) and tumour necrosis factor-alpha (TNF-α) were independently associated with obesity after adjustment for age, sex, medication use, and asymptomatic malaria; hs-CRP showed the strongest and most robust association. The cross-sectional design prevents causal inference, and generalizability to other populations is limited by the West African setting and near-universal metformin use in the cohort.
Cross-sectional case-control study. 151 adults with type 2 diabetes and 100 age- and sex-frequency-matched healthy controls from Southwest Nigeria. Intervention: Measurement of inflammatory biomarkers (hs-CRP, TNF-α, IL-6). Compared with: Obesity status (BMI ≥ 30 kg/m² vs. BMI < 30 kg/m²); T2DM group vs. healthy control group for biomarker concentration comparison. n = 251. Southwest Nigeria.
Participants with T2DM had significantly higher hs-CRP, TNF-α, and IL-6 concentrations than controls (all p < 0.001) hs-CRP showed strongest correlation with body mass index (ρ = 0.42, p < 0.001) and waist circumference (ρ = 0.38, p < 0.001) In fully adjusted models, hs-CRP (aOR = 1.35, 95% CI: 1.10–1.66, p = 0.004) and TNF-α (aOR = 1.06, 95% CI: 1.01–1.12, p = 0.018) were associated with obesity
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The robust association between hs-CRP and obesity in this T2DM cohort suggests hs-CRP may be a practical biomarker to identify individuals with obesity-related inflammation; however, the cross-sectional design prevents determination of whether hs-CRP is a cause, consequence, or marker of obesity. Prospective studies are needed to establish whether hs-CRP measurement would meaningfully guide clinical management or prognostication in this population.
Cross-sectional observational study with clear associations between inflammatory biomarkers and obesity in a defined population, but cross-sectional design precludes causal inference and generalizability beyond Southwest Nigeria is uncertain.
As stated by the source record.
Quoted from the source exactly as published.
The robust association between hs-CRP and obesity in this T2DM cohort suggests hs-CRP may be a practical biomarker to identify individuals with obesity-related inflammation; however, the cross-sectional design prevents determination of whether hs-CRP is a cause, consequence, or marker of obesity. Prospective studies are needed to establish whether hs-CRP measurement would meaningfully guide clinical management or prognostication in this population.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Inflammation contributes to obesity-related metabolic dysfunction in type 2 diabetes (T2DM), yet evidence from sub-Saharan Africa remains limited, particularly from studies adjusting for medication use and endemic infections. This study investigated associations between high-sensitivity C-reactive protein (hs-CRP), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and obesity in Nigerian adults with T2DM, adjusting for medication use and asymptomatic malaria. This cross-sectional study included 151 adults with T2DM and 100 age- and sex-frequency-matched healthy controls from Southwest Nigeria. Plasma inflammatory markers were measured by enzyme-linked immunosorbent assay. Multivariable logistic regression examined associations with obesity (body mass index ≥ 30 kg/m²), adjusting for age, sex, metformin use, statin use, and asymptomatic malaria rapid diagnostic test status. All models were restricted to participants with T2DM; near-universal metformin use (98%) limited the ability to estimate its independent effect. Sensitivity analyses included log-transformed biomarker concentrations. Participants with T2DM had significantly higher hs-CRP, TNF-α, and IL-6 concentrations than controls (all p < 0.001). hs-CRP showed the strongest correlation with body mass index (ρ = 0.42, p < 0.001) and waist circumference (ρ = 0.38, p < 0.001). In fully adjusted models, hs-CRP (aOR = 1.35, 95% CI: 1.10–1.66, p = 0.004) and TNF-α (aOR = 1.06, 95% CI: 1.01–1.12, p = 0.018) were associated with obesity, whereas IL-6 was not (aOR = 1.04, 95% CI: 0.99–1.09, p = 0.118). When all three biomarkers were included simultaneously, hs-CRP remained associated with obesity (aOR = 1.32, 95% CI: 1.08–1.62, p = 0.007), whereas TNF-α and IL-6 did not. Sensitivity analyses yielded materially similar findings. Inflammatory biomarkers, particularly hs-CRP, were associated with obesity in Nigerian adults with T2DM. The consistent association of hs-CRP with obesity suggests this readily measurable biomarker may help identify individuals with obesity-related inflammation, though prospective studies are needed to establish clinical utility. The near-universal metformin use limits interpretation, and the cross-sectional design precludes causal inference. Not applicable (observational study).
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