Time for a More Precise and Practical Laboratory Definition of Metainflammation in Obesity-Related Diseases

Background/Objectives: Metainflammation is a chronic low-grade inflammatory state driven by excessive nutrition and obesity. It is associated with adipocyte dysfunction, altered adipokine secretion, and the development of insulin resistance, which contributes to dysglycemia and hyperglycemia. Recent initiatives emphasize earlier recognition of pathological processes to enable timely detection and primary prevention of adverse cardiovascular outcomes. Metainflammation has traditionally been assessed using serum C-reactive protein (CRP) levels and several proposed indices, with inconsistent performance due to chronic inflammation-related changes in blood cell counts. This study aimed to evaluate a newly proposed MetaLGI score as a laboratory-based tool for identifying pronounced metainflammation in patients with metabolic syndrome. Methods: Patients with metabolic syndrome were assessed for metainflammation using the newly proposed MetaLGI score and compared with previously suggested indices and CRP-based definitions. The ability of these approaches to identify pronounced metainflammation and associated hematological and metabolic alterations was evaluated. Results: The MetaLGI score demonstrated superiority in recognizing pronounced metainflammation in patients with metabolic syndrome compared to previous indices. Additionally, the proposed laboratory definition of metainflammation showed better performance in identifying patients with increased platelet counts, highlighting its relevance for inflammation-related cardiovascular thrombosis. MetaLGI also outperformed earlier proposals in identifying patients with increased β-cell burden. Conclusions: The newly proposed MetaLGI score represents a superior and widely available laboratory-based method for detecting pronounced metainflammation in patients with metabolic syndrome. Its improved ability to identify increased platelet counts and β-cell burden suggests potential value for early risk stratification and primary prevention of cardiometabolic complications.