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Multicenter Study
. 2021 Jan;16(1):e12696.
doi: 10.1111/ijpo.12696. Epub 2020 Jul 8.

Significance of autoantibody seropositivity in children with obesity and non-alcoholic fatty liver disease

Toshifumi Yodoshi  1 , Sarah Orkin  1 , Ana Catalina Arce-Clachar  1   2 , Kristin Bramlage  1 , Stavra A Xanthakos  1   2 , Marialena Mouzaki  1   2 , Pamela L Valentino  3
Affiliations
Multicenter Study

Significance of autoantibody seropositivity in children with obesity and non-alcoholic fatty liver disease

Toshifumi Yodoshi et al. Pediatr Obes. 2021 Jan.

Abstract

Background: Autoantibodies are frequently positive in adults with nonalcoholic fatty liver disease (NAFLD) without concurrent autoimmune hepatitis (AIH). The clinical significance of this is unknown in children.

Objective: To determine the prevalence of autoantibody positivity in pediatric NAFLD and to evaluate its association with disease severity.

Methods: Multicenter, retrospective study of patients ≤18 years of age with biopsy-confirmed NAFLD. Descriptive statistics were used and groups were compared using Wilcoxon-Mann Whitney or χ2 testing, and multivariable logistic regression was used for binary or ordinal outcomes.

Results: One hundred and thirty six patients with a median age of 14 years were included. The median body mass index Z-score was 2.5 (interquartile range 2.2, 2.6). Positive antinuclear antibody (ANA), anti-smooth muscle antibody (ASMA), anti-liver-kidney microsomal antibody, or any combination of autoantibodies were observed in 22%, 14%, 0%, and 33% of patients, respectively. The proportion of patients with a steatosis score ≥2 was significantly higher in those with positive ANA (P = .045). In the multivariable regression analysis, positive ANA was associated with increased odds of steatosis score ≥2 (odds ratio, 5.91; 95% confidential interval, 1.50-23.26), after controlling for potential confounders. No other significant histology differences were seen between the groups.

Conclusions: Positive ANA and ASMA are common in children with NAFLD; however, anti-LKM positivity is not. ANA positivity is associated with more severe steatosis.

Keywords: anti-smooth muscle antibody; antinuclear antibody; elevated liver transaminases; liver biopsy; non-alcoholic steatohepatitis.

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Conflict of interest statement

CONFLICT OF INTEREST

None of the authors have any potential conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Comparison of the proportion of patients with positive autoantibodies by nonalcoholic fatty liver disease (NAFLD) Activity Score severity
See this image and copyright information in PMC

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