Circulating adipokines in children with nonalcoholic fatty liver disease: possible noninvasive diagnostic markers

Abstract

Background: The growing obesity pandemic is the leading cause for increasing prevalence of nonalcoholic fatty liver disease (NAFLD) in children. Histopathological evaluation of the liver remains the gold standard for NAFLD diagnosis, but it is an invasive procedure with a low but real risk of morbidity and mortality. The current study evaluated circulating chemerin and adiponectin as possible noninvasive diagnostic markers for NAFLD in obese non-diabetic children.

Methods: A prospective case-control study was conducted, which included 101 obese children with biopsy-proven NAFLD and 57 age- and sex-matched controls. The overall mean age of the children was 10.08±3.12 years. All underwent a full clinical assessment, routine laboratory investigation, and abdominal ultrasound. Homeostatic model assessment-insulin resistance was calculated and circulating chemerin and adiponectin were evaluated using ELISA.

Results: Elevated serum chemerin and decreased serum adiponectin were significantly associated with an increased likelihood of exhibiting NAFLD. Receiver operator characteristic curve analysis for differentiation of NAFLD patients from those in the control group demonstrated that chemerin, at a cutoff value of 186.7 ng/mL, yielded a sensitivity and specificity of 56.44% and 87.72% respectively (P<0.001), whereas adiponectin, at a cutoff value of 2.4 µg/mL, had a sensitivity and specificity of 74.26% and 3.51% respectively (P<0.001). Furthermore, body mass index, aspartate transaminase, alanine transaminase, triglycerides, and gamma-glutamyl transferase had significant positive correlations with chemerin and significant negative correlations with adiponectin (P≤0.001).

Conclusion: Circulating chemerin and adiponectin could serve as simple noninvasive diagnostic markers for NAFLD in non-diabetic obese children.

Keywords: Diagnosis; nonalcoholic fatty liver disease; noninvasive; obese children.

Figure 1

The frequency (percentage) of histologic findings in the nonalcoholic fatty liver disease group. The degree of steatosis (top), lobular inflammation degree based on foci of lobular inflammation in high power field of microscopic view (middle), and fibrosis degree (bottom)

Figure 2

Receiver operator characteristic curves for the diagnostic power of chemerin and adiponectin at various cutoff points in differentiating between patients with nonalcoholic fatty liver disease and controls