Inflammatory Markers Among African American Adolescents with Type 2 Diabetes Mellitus and Obesity: A Cross-Sectional Study

Background/Objectives: Type 2 diabetes (T2D), a chronic metabolic disorder characterized by systemic inflammation, disproportionately affects African American adolescents. Metformin may reduce inflammation beyond glycemic control; however, its impact on inflammatory markers in adolescents remains unclear. We hypothesized that inflammatory markers would differ across groups defined by diabetes, obesity, and metformin use. Methods: In this cross-sectional analysis, inflammatory markers (C-reactive protein [CRP], interleukin-6 [IL-6], and tumor necrosis factor-alpha [TNF-α]), metabolic panels, and metformin exposure were assessed in African American adolescents from Children’s of Alabama. Simple and multivariate linear regression models were used to test associations between metformin use and inflammatory markers, adjusting for age, sex, and BMI z-score. Results: Among 78 adolescents, metformin use was reported in 73.6% of those with T2D + obesity and 27.3% of those with obesity-only. In the T2D + obesity group, metformin use was associated with TNF-α (β = 0.34, p = 0.02). Conclusions: Metformin use was associated with higher levels of specific inflammatory markers, potentially reflecting that metformin was more likely utilized in more severe diseases. Longitudinal studies are needed to disentangle treatment effects from underlying disease progression.