title: Role of Serum Biomarkers in Early Detection of Non-Alcoholic Steatohepatitis and Fibrosis in West Virginian Children.
abstract: BACKGROUND
  Obesity, an epidemic among West Virginia children, as well as insulin resistance (IR), is well-established contributors to nonalcoholic steatohepatitis (NASH). Progression of NASH can lead to hepatic fibrosis and cirrhosis, making early detection imperative. The standard for diagnosing NASH is histologicallyvialiver biopsy, which is highly invasive and generally contraindicated in children. By studying serum biomarkers associated with NASH, we aim to identify high risk children who can benefit from a less invasive, alternative approach to the early detection of NASH.
  
  
  METHODS
  Seventy one children were prospectively recruited and divided into 3 groups:normal weight without IR (control), obese without IR, and obese with IR. Serum samples were drawn for each patient and biomarker levels were assessedviaELISA kits.
  
  
  RESULTS
  Obese without IRandobese with IRpatients had significantly elevated levels of lipid metabolism and accumulation markers (FGF-21, NEFA, FATP5, ApoB), oxidative stress markers (dysfunctional HDL, 8-Isoprostane), inflammatory markers(dysfunctional HDL, CK-18) and apoptosis markers (CK-18) compared to control patients (p<0.02). Bilirubin (an antioxidant) was significantly decreased in theobese without IRandobese with IRpatients compared to control (p<0.02).
  
  
  CONCLUSIONS
  This study showed a correlation between obesity, IR, and biomarkers associated with NASH in pediatrics patients from West Virginia, with obese with IR patients showing the strongest correlation. These findings support the clinical application of these serum biomarkers as a less invasive method for early detection of NASH and hepatic fibrosis.
authors.affiliation: Department of Surgery and Pharmacology, Joan C. Edwards School of Medicine, Marshall University, USA.
authors.forename: Komal
authors.initials: K
authors.lastname: Sodhi
authors.affiliation: Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, USA.
authors.forename: Lucas
authors.initials: L
authors.lastname: Bracero
authors.affiliation: Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Feyh
authors.affiliation: Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nichols
authors.affiliation: Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, USA.
authors.forename: Krithika
authors.initials: K
authors.lastname: Srikanthan
authors.affiliation: Department of Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, USA.
authors.forename: Tariq
authors.initials: T
authors.lastname: Latif
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Joan C. Edwards School of Medicine, Marshall University, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Preston
authors.affiliation: Department of Surgery and Pharmacology, Joan C. Edwards School of Medicine, Marshall University, USA.
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Shapiro
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Joan C. Edwards School of Medicine, Marshall University, USA.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Elitsur
keywords: Biomarkers; Nonalcoholic fatty liver (NAFL); Pediatric Non-alcoholic steatohepatitis (NASH)