Serum concentration of adiponectin, leptin and resistin  in obese children with non-alcoholic fatty liver disease.
OBJECTIVE
Obesity, insulin resistance and dyslipidemia are the most significant risk factors of non-alcoholic fatty liver disease (NAFLD) but the role of adipokines in patomechanism of this disease is not clear. The aim of the study was to evaluate the serum levels of leptin, adiponectin and resistin in obese children with NAFLD.


METHODS
The fasting serum levels of adipokines were determined in 44 consecutive obese children with suspected liver disease and in 24 lean controls. The degree of the ultrasound liver steatosis was graded according to Saverymuttu.


RESULTS
The fatty liver was confirmed in 33 children by ultrasonography (16 of them also showed an increased ALT activity). The serum leptin level was significantly higher and adiponectin level was lower in the obese children with NAFLD when compared to controls. Only adiponectin correlated with homeostasis model assessment of insulin resistance (HOMA-IR). Significant negative correlations were found between the ultrasonographic grades of liver steatosis and adiponectin and resistin levels. Serum adiponectin and resistin levels were lower in children with an advanced liver steatosis (grade 3, n=10) compared to patients with a mild steatosis (grade 1-2, n=23). The ability of serum adiponectin and resistin to differentiate children with an advanced liver steatosis from those with mild steatosis was significant.


CONCLUSIONS
These data suggest a role of both adiponectin and resistin in the pathogenesis of NAFLD in obese children and confirm the association between adiponectin and insulin resistance. Adiponectin and resistin may be suitable serum markers in predicting an advanced liver steatosis in children with NAFLD.
Lebensztejn
D M
DM
Department of Pediatrics, Gastroenterology and Allergology, Medical University of Bialystok, Poland. lebensztejn@hoga.pl
Wojtkowska
M
M
Skiba
E
E
Werpachowska
I
I
Tobolczyk
J
J
Kaczmarski
M
M
D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002648:Child; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005234:Fatty Liver / Q000097:blood* / Q000000981:diagnostic imaging; D005260:Female; D006529:Hepatomegaly / Q000097:blood; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D020738:Leptin / Q000097:blood*; D008297:Male; D009765:Obesity / Q000097:blood*; D011446:Prospective Studies; D052243:Resistin / Q000097:blood*; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood
D052242:Adiponectin; D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D020738:Leptin; D052243:Resistin; D002784:Cholesterol; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase