Department of Pediatrics, Gastroenterology and Allergology, Medical University of Bialystok, Bialystok, Poland.
Department of Pediatrics and Developmental Disorders, Medical University of Bialystok, Bialystok, Poland.
Adv Med Sci. 2014 Mar;59(1):81-4. doi: 10.1016/j.advms.2013.08.003. Epub 2014 Mar 22.
To assess the serum fetuin A concentration as a potential marker of subclinical atherosclerosis in obese children with NAFLD.
MATERIAL/METHODS: A prospective analysis of 45 obese children initially diagnosed with liver pathology (elevated serum ALT activity and/or ultrasonographic liver brightness and/or hepatomegaly) was conducted. The diagnosis of NAFLD was established in the children with elevated serum ALT activity and liver steatosis on ultrasound examination. Viral hepatitis, autoimmune, metabolic liver diseases (Wilson disease, alpha-1-antitrypsin deficiency, cystic fibrosis) and drug and toxin-induced liver injury were excluded in all children. The degree of liver steatosis was graded according to Saverymuttu scale and the total liver lipids concentration was assessed using proton magnetic resonance spectroscopy ((1)H MRS).
Serum fetuin A concentration was significantly higher in examined children compared to the control group (n=30) (p=0.00002). Higher serum fetuin A concentration was also observed in children with NAFLD (n=19) in comparison to the controls (p=0.000026). Additionally, higher BMI values, waist circumferences, ALT and GGT activity, intensity of liver steatosis on ultrasound and total concentration of lipids in the liver in (1)H MRS were found in children with NAFLD compared to the rest of the examined obese patients (n=26). There was not found any correlation of the investigated glycoprotein with any other assessed parameters both in children with NAFLD and obese children without NAFLD.
Higher serum fetuin A concentration found in children with NAFLD compared to the control group support the hypothesis that atherosclerotic processes may develop faster in hepatopatic obese patients.
评估血清胎球蛋白 A 浓度作为非酒精性脂肪性肝病肥胖儿童亚临床动脉粥样硬化的潜在标志物。
材料/方法:对 45 名最初被诊断为肝病理(血清 ALT 活性升高和/或超声肝亮度升高和/或肝肿大)的肥胖儿童进行前瞻性分析。在血清 ALT 活性升高和超声检查肝脂肪变性的儿童中确立了非酒精性脂肪性肝病的诊断。所有儿童均排除了病毒性肝炎、自身免疫性、代谢性肝病(Wilson 病、α-1-抗胰蛋白酶缺乏症、囊性纤维化)和药物及毒素引起的肝损伤。根据 Saverymuttu 量表对肝脂肪变性程度进行分级,并使用质子磁共振波谱(1H MRS)评估总肝脂质浓度。
与对照组(n=30)相比,检查儿童的血清胎球蛋白 A 浓度明显升高(p=0.00002)。与对照组相比(p=0.000026),NAFLD 患儿(n=19)的血清胎球蛋白 A 浓度也更高。与其余检查肥胖患者(n=26)相比,NAFLD 患儿的 BMI 值、腰围、ALT 和 GGT 活性、超声肝脂肪变性强度和 1H MRS 肝总脂质浓度更高。在有和没有 NAFLD 的肥胖儿童中,均未发现该研究糖蛋白与任何其他评估参数之间存在相关性。
与对照组相比,NAFLD 患儿的血清胎球蛋白 A 浓度较高,支持了这样一种假说,即肝源性肥胖患者的动脉粥样硬化过程可能发展得更快。