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Background: Serum and urinary uromodulin are emerging as potential cardiovascular risk factors. The aim of our study was to determine uromodulin in both serum and urine to evaluate their potential as early cardiovascular risk markers and markers of kidney function in children and young adults., Methods: This case-control study included 72 participants - 42 children and young adults with chronic kidney disease stages 1-2 and 30 healthy controls. Serum and urinary uromodulin concentrations were determined along with anthropometric measurements, body composition, and standard laboratory measurements in cardiovascular and kidney health assessment., Results: Urinary uromodulin-to-creatinine was significantly decreased in the group with chronic kidney disease (p < 0.001). It also correlated significantly with anthropometric measurements, systolic pressure, creatinine (but not with glomerular filtration rate), urate, and homocysteine. Serum uromodulin did not differ from healthy control subjects. Serum uromodulin correlated significantly with albuminuria, showing its minor potential in kidney health assessment in the young., Conclusions: Urinary uromodulin is a better predictor of kidney and cardiovascular early damage than serum uromodulin in children and young adults with only mild chronic kidney disease. In at-risk individuals, lower urinary uromodulin levels might reflect a reduced functional kidney and cardiovascular reserve. Further research in the pediatric population is warranted., Competing Interests: Declarations. Ethics approval: Parents, legal guardians, or adult participants received written information about the research protocol and provided informed consent by signing a declaration to participate. The study followed the principles outlined in the Declaration of Helsinki and obtained approval from both the Medical Ethics Commission of the University Clinical Center Maribor (UKC-MB-KME-35/20) and the Medical Ethics Commission of the Republic of Slovenia (0210–372/2020/6). Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)

Background: Systemic inflammation and oxidative stress are fundamental contributors to the onset of conditions related to childhood obesity, such as cardiovascular (CV) diseases. We aimed to assess CV risk in childhood obesity by examining sex differences in adiposity indices, cardiometabolic profiles, inflammation, and oxidative stress biomarkers. We also aimed to assess the potential of the interferon-inducible T-cell alpha chemoattractant (I-TAC/CXCL11) as a novel biomarker. Methods: Eighty children (36 girls) aged 5-18 years with overweight, obesity, or normal weight were analyzed. Fasting blood samples were obtained to assess C-reactive protein (CRP), leukocytes, myeloperoxidase (MPO), adiponectin, monocyte chemoattractant protein-1, superoxide dismutase-1, I-TAC/CXCL11, and a comprehensive cardiometabolic profile, including glucose, lipid, renal, liver, and thyroid function markers. Adiposity indices were determined using bioelectrical impedance analysis (BIA) and anthropometric measures, including BMI, waist-to-hip and waist-to-height ratios, and visceral and subcutaneous fat thickness. Blood pressure (BP) and pulse wave velocity were also evaluated. Results: Girls had less central obesity and fewer CV risk factors than boys, despite having similar total fat mass. Both girls and boys with overweight or obesity showed higher CRP levels. Girls with excess weight had increased leukocyte counts, while boys had elevated MPO levels, which correlated positively with adiposity indices, systolic BP, and homocysteine, and negatively with HDL. I-TAC/CXCL11 levels were similar across groups. Conclusions: Adiposity indices are essential for evaluating CV risk in children and adolescents, with sex differences underscoring the need for tailored approaches. MPO correlated significantly with CV risk markers, supporting its inclusion in routine assessments. I-TAC/CXCL11 warrants further study in childhood obesity.

Metabolic syndrome (MetS) is associated with systemic inflammation, oxidative stress, and hypovitaminosis D. Our aim was to determine whether vitamin D mediates inflammation and oxidative stress, assessed through selected biomarkers, in children with obesity and/or MetS. Eighty children with normal weight, overweight, or obesity were analyzed for serum vitamin D, C-reactive protein, leukocytes, adiponectin, monocyte chemoattractant protein-1, myeloperoxidase, interferon-inducible T-cell alpha chemoattractant (I-TAC/CXCL11), superoxide dismutase-1, fasting lipid and glucose levels, ultrasound-measured abdominal fat thickness, waist circumference, body mass index and blood pressure. Children with obesity or overweight had lower vitamin D levels, increased blood pressure, visceral and subcutaneous fat thickness, and higher leukocytes, C-reactive protein, and myeloperoxidase levels. Those with MetS also had lower adiponectin levels. Vitamin D levels are negatively correlated with body mass index, waist circumference, and visceral and subcutaneous fat thickness. Correlation, mediation, and regression analyses showed no link between vitamin D and inflammatory/oxidative stress variables. The novel biomarker I-TAC did not correlate with obesity or vitamin D status. Our results indicate that vitamin D does not significantly mediate inflammation or oxidative stress in children and adolescents with obesity and/or MetS. Selected inflammation/oxidative stress biomarkers appear to be altered primarily due to obesity rather than vitamin D status.