Fetuin-A and its relation to metabolic syndrome and fatty liver disease in obese children before and after weight loss.
BACKGROUND
There are very limited data available concerning the relationships between fetuin-A, weight status, nonalcoholic fatty liver disease (NAFLD), and features of the metabolic syndrome (MetS) in obese humans, and especially in children.


OBJECTIVE
Our objective was to study the longitudinal relationships between fetuin-A, NAFLD, and MetS in obese children.


METHODS
This was a 1-yr longitudinal follow-up study.


METHODS
This study was performed in primary care.


METHODS
A total of 36 obese and 14 lean children was included in the study.


METHODS
An outpatient 1-yr intervention program based on exercise, behavior, and nutrition therapy was performed.


METHODS
Changes of weight status (sd score-body mass index), waist circumference, fetuin-A, blood pressure, lipids, transaminases, insulin resistance index homeostasis model assessment (HOMA), and prevalence of NAFLD (defined by liver ultrasound) were calculated.


RESULTS
The 12 obese children with NAFLD had significantly higher fetuin-A levels (0.35+/-0.07 g/liter) than the 24 obese children without NAFLD (0.29+/-0.06 g/liter) and the 14 normal weight children (0.29+/-0.05 g/liter). Fetuin-A levels were independent of age, pubertal stage, and gender. Fetuin-A correlated significantly to systolic (r=0.50) and diastolic blood pressure (r=0.41), insulin resistance index HOMA (r=0.28), and high-density lipoprotein-cholesterol (r=-0.31). Changes of fetuin-A correlated significantly to changes of insulin resistance index HOMA (r=0.34), systolic (r=0.31) and diastolic blood pressure (r=0.37), and waist circumferences (r=0.36). Substantial weight loss in 21 children led to a significant decrease of fetuin-A and the prevalence of NAFLD in contrast to the 15 children without substantial weight loss.


CONCLUSIONS
Fetuin-A levels were higher in children with NAFLD, and were related to insulin resistance and to features of the MetS in both cross-sectional and longitudinal analyses. Therefore, fetuin-A might be a new promising link between obesity and its comorbidities.
Reinehr
Thomas
T
Department of Pediatric Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Dr. F. Steiner Str. 5, D-45711 Datteln, Germany. T.Reinehr@kinderklinik-datteln.de
Roth
Christian L
CL
D001521:Behavior Therapy; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D001798:Blood Proteins / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D015444:Exercise; D005234:Fatty Liver / Q000097:blood* / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D009765:Obesity / Q000097:blood*; D011627:Puberty; D012016:Reference Values; D015431:Weight Loss; D060749:alpha-2-HS-Glycoprotein
C556354:AHSG protein, human; D001786:Blood Glucose; D001798:Blood Proteins; D007328:Insulin; D008055:Lipids; D060749:alpha-2-HS-Glycoprotein