Cianfarani Stefano, Inzaghi Elena, Alisi Anna, Germani Daniela, Puglianiello Antonella, Nobili Valerio
Department of Pediatrics, University Hospital, Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy; Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
Department of Pediatrics, University Hospital, Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy.
J Pediatr. 2014 Jul;165(1):92-8. doi: 10.1016/j.jpeds.2014.01.052. Epub 2014 Mar 5.
To correlate circulating levels of insulin-like growth factor (IGF)-I, IGF-II, and IGF binding protein (IGFBP)-3 in a population of obese children with biopsy-proven nonalcoholic fatty liver disease (NAFLD) with clinical, biochemical, and histological features.
We conducted a cross-sectional study at the Hepatometabolic Unit of the Bambino Gesù Children's Hospital, Rome, Italy. Obese children (42 girls and 57 boys) underwent liver biopsy, anthropometry, biochemical assessment, and IGF system evaluation. Serum concentrations of IGF-I, IGF-II, and IGFBP-3 were measured. The liver biopsy features of each case were graded according to the NAFLD Activity Scoring system. The degrees of steatosis, inflammation, ballooning, and fibrosis were calculated.
Nonalcoholic steatohepatitis was diagnosed in 14/99 obese subjects. Stepwise regression analysis revealed that IGF-I was the major predictor of ballooning (β = -0.463; P < .0001) and NAFLD activity score (β = -0.457; P < .0001), IGF-I/IGFBP-3 ratio was the major predictor of liver inflammation (β = -0.285; P = .005), and IGF-II was the major predictor of liver fibrosis (β = 0.343; P < .005).
Circulating levels of IGF-I and IGF-II are associated with the histological stages of NAFLD and may represent novel markers of liver damage progression in obese children.
在经活检证实患有非酒精性脂肪性肝病（NAFLD）的肥胖儿童群体中，将胰岛素样生长因子（IGF）-I、IGF-II和IGF结合蛋白（IGFBP）-3的循环水平与临床、生化和组织学特征进行关联分析。
我们在意大利罗马的 Bambino Gesù儿童医院的肝脏代谢科进行了一项横断面研究。肥胖儿童（42名女孩和57名男孩）接受了肝脏活检、人体测量、生化评估和IGF系统评估。测量了血清中IGF-I、IGF-II和IGFBP-3的浓度。根据NAFLD活动评分系统对每个病例的肝脏活检特征进行分级。计算了脂肪变性、炎症、气球样变和纤维化的程度。
在99名肥胖受试者中，有14名被诊断为非酒精性脂肪性肝炎。逐步回归分析显示，IGF-I是气球样变（β = -0.463；P <.0001）和NAFLD活动评分（β = -0.457；P <.0001）的主要预测因子，IGF-I/IGFBP-3比值是肝脏炎症（β = -0.285；P =.005）的主要预测因子，IGF-II是肝脏纤维化（β = 0.343；P <.005）的主要预测因子。
IGF-I和IGF-II的循环水平与NAFLD的组织学阶段相关，可能代表肥胖儿童肝脏损伤进展的新标志物。
