Adipocytokines as Risk Factors for Development of Nonalcoholic Fatty Liver Disease in Children

Paweł Małecki; Anna Mania; Joanna Tracz; Magdalena Łuczak; Katarzyna Mazur-Melewska; Magdalena Figlerowicz

doi:10.1016/j.jceh.2021.03.002

Adipocytokines as Risk Factors for Development of Nonalcoholic Fatty Liver Disease in Children

J Clin Exp Hepatol. 2021 Nov-Dec;11(6):646-653. doi: 10.1016/j.jceh.2021.03.002. Epub 2021 Mar 10.

Authors

Paweł Małecki¹, Anna Mania¹, Joanna Tracz², Magdalena Łuczak², Katarzyna Mazur-Melewska¹, Magdalena Figlerowicz¹

Affiliations

¹ Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, Poznan, Poland.
² Institute of Bioorganic Chemistry, Polish Academy of Sciences, Poznan, Poland.

Abstract

Background: Noninvasive diagnostics of nonalcoholic fatty liver disease (NAFLD), the most common cause of liver dysfunction in children, are based on imaging, biochemical tests and their compilation. The study aimed to evaluate the serological biomarkers of steatosis, inflammation and liver fibrosis to assess the risk of NAFLD in children.

Methods: A total of 73 children were included in the prospective study; 50 of them were diagnosed with NAFLD based on ultrasound, and 23 formed a control group. Basic anthropometric parameters were measured, blood samples were taken for laboratory tests and evaluated proteins were assessed by enzyme-linked immunosorbent assay-adiponectin, tumour necrosis factor alpha, fibroblast growth factor 21, liver fatty acid-binding protein (L-FABP) and interleukin 6.

Results: Statistically significant differences between the levels of two proteins were found: the adiponectin level was lower in the NAFLD group (12.24 ± 7.01 vs 16.88 ± 9.21 μg/mL, P = 0.024), and L-FABP levels were higher (21.48 ± 20.61 vs 11.74 ± 8.39 ng/mL, P = 0.031). In the group of children with body mass index (BMI)-for-age >1 standard deviation (SD), adiponectin concentration was also significantly lower (12.18 ± 6.43 μg/mL) than in the group with BMI ≤1 SD (17.29 ± 9.42 μg/mL, P = 0.015). The odds ratios and 95% confidence interval for the relation between adiponectin and NAFLD and obesity were 0.868 (0.767-0.982) and 0.838 (0.719-0.977), respectively.

Conclusion: Adiponectin may be useful in evaluating the risk of NAFLD and obesity in children.

Keywords: ALF, acute liver failure; ALT, alanine aminotransferase; AMPK, adenosine monophosphate–activated protein kinase; APRI, AST to Platelet Ratio Index; AST, aspartate aminotransferase; BMI, body mass index; ER, endoplasmic reticulum; FFA, free fatty acid; FGF-21, fibroblast growth factor 21; HMW, high-molecular-weight; IR, insulin resistance; L-FABP, liver fatty acid-binding protein; LPS, lipopolysaccharide; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; OR, odds ratio; PNFS, Paediatric NAFLD Fibrosis Scale; PPAR-α, peroxisome proliferator–activated receptor-α; SD, standard deviation; SOCS3, suppressor of cytokine signalling 3; TNF-α, tumour necrosis factor α; US-FLI, ultrasound fatty liver indicator; WHO, World Health Organization; adipokines; children; nonalcoholic fatty liver disease.