Decreased serum adiponectin: an early event in pediatric nonalcoholic fatty liver disease.
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.
Louthan
Miriam Vos
MV
Division of Gastroenterology and the Department of Pediatrics, University of Louisville, University of Louisville Medical Center, Louisville, Ky 40202, USA. mlouthan@childrensmemorial.org
Barve
Shirish
S
McClain
Craig J
CJ
Joshi-Barve
Swati
S
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
D052242:Adiponectin; D016207:Cytokines; D000410:Alanine Transaminase