title: Decreased serum adiponectin: an early event in pediatric nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  To evaluate the relative concentrations of cytokines in pediatric nonalcoholic fatty liver disease (NAFLD).
  
  
  METHODS
  Thirty children were evaluated at a fasting morning visit to a pediatric research unit.
  
  
  RESULTS
  Compared with normal-weight children (n = 12) and children who were overweight (n = 11), children who had presumed NAFLD (elevated Alanine aminotransferase [ALT] with negative work-up) (n = 7) had significantly lower mean serum adiponectin levels (P = .004). Adiponectin negatively correlated with body mass index (r = -0.60, P = .001), insulin (r = -0.74, P < .001), glucose (r = -0.52, P = .004), and ALT (r = -0.53, P = .003). There was no difference between normal-weight, obese, and presumed NAFLD subjects in mean serum tumor necrosis factor alpha and interleukin-6 and -8 concentrations nor in tumor necrosis factor alpha and interleukin-8 and -10 levels in an ex vivo lipopolysaccharide-stimulated system.
  
  
  CONCLUSIONS
  Serum adiponectin is reduced in children with elevated ALT, similar to adults. However, children with presumed NAFLD do not have elevated pro-inflammatory cytokine levels. This suggests that depressed adiponectin plays a more proximal role than elevated levels of circulating pro-inflammatory cytokines in the development of NAFLD in children.
authors.affiliation: Division of Gastroenterology and the Department of Pediatrics, University of Louisville, University of Louisville Medical Center, Louisville, Ky 40202, USA. mlouthan@childrensmemorial.org
authors.forename: Miriam Vos
authors.initials: MV
authors.lastname: Louthan
authors.forename: Shirish
authors.initials: S
authors.lastname: Barve
authors.forename: Craig J
authors.initials: CJ
authors.lastname: McClain
authors.forename: Swati
authors.initials: S
authors.lastname: Joshi-Barve
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D016207:Cytokines / Q000097:blood; D005234:Fatty Liver / Q000097:blood* / Q000503:physiopathology; D006801:Humans; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood* / Q000503:physiopathology
chemical_list: D052242:Adiponectin; D016207:Cytokines; D000410:Alanine Transaminase