title: Analysis of adipokine concentrations in paediatric non-alcoholic fatty liver disease.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children. It is important to distinguish children with more severe disease or steatohepatitis (NASH) from those with the less severe simple steatosis (SS) as prognosis differs. The importance of adipokines in the evolution of NASH is well recognized.
  
  
  OBJECTIVE
  As adipokines are important in mediating inflammation, they may also be useful biomarkers of disease.
  
  
  METHODS
  Plasma from 40 children (30 boys), median age 13.4 years, with liver biopsy-proven NAFLD was analysed. Liver biopsies were scored using the NAFLD activity score and compared with adipokine concentrations.
  
  
  RESULTS
  Median body mass index z-score was 2.12 with a median homeostasis model of assessment- insulin resistance of 4.08. Resistin was lower in NASH than in SS (P = 0.03). Monocyte chemoattractant protein 1 (MCP-1) was also lower in NASH (P = 0.04). MCP-1 was higher in children with severe fibrosis (P = 0.008) with an area under the receiver operating characteristic curve (AUROC) of 0.76. Plasminogen activator inhibitor 1 (PAI-1) was also higher in this group (P = 0.011) with an AUROC of 0.78. There were no significant differences in leptin, adiponectin, adipsin, interleukin (IL) 6, IL10 or tumour necrosis factor α between groups.
  
  
  CONCLUSIONS
  PAI-1 MCP-1 and resistin were differentially expressed with increasing severity of NAFLD. Though it is unlikely that this profile alone would serve as a biomarker of disease, differences found may contribute to understanding the role of these mediators in NAFLD.
authors.affiliation: Paediatric Liver, GI and Nutrition Centre, King's College London School of Medicine, London, UK. emer.fitzpatrick@kcl.ac.uk
authors.forename: E
authors.initials: E
authors.lastname: Fitzpatrick
authors.forename: T K
authors.initials: TK
authors.lastname: Dew
authors.forename: A
authors.initials: A
authors.lastname: Quaglia
authors.forename: R A
authors.initials: RA
authors.lastname: Sherwood
authors.forename: R R
authors.initials: RR
authors.lastname: Mitry
authors.forename: A
authors.initials: A
authors.lastname: Dhawan
mesh_terms: D054392:Adipokines / Q000097:blood*; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D018932:Chemokine CCL2 / Q000097:blood; D002648:Child; D005234:Fatty Liver / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000473:pathology; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011379:Prognosis; D052243:Resistin / Q000097:blood
chemical_list: D054392:Adipokines; D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D017395:Plasminogen Activator Inhibitor 1; D052243:Resistin