Pampanini V, Inzaghi E, Germani D, Alterio A, Puglianiello A, Alisi A, Nobili V, Cianfarani S
Department of Women's and Children's Health, Pediatric Endocrinology Unit, Karolinska Institutet and University Hospital, 17176, Stockholm, Sweden.
Dipartimento Pediatrico Universitario Ospedaliero "Bambino Gesù" Children's Hospital - Tor Vergata University, 00165, Rome, Italy.
Nutr Metab Cardiovasc Dis. 2018 Jan;28(1):71-76. doi: 10.1016/j.numecd.2017.09.008. Epub 2017 Oct 3.
Fetuin-A has been proposed as a marker of liver damage in adults with obesity-related NAFLD. The aim of this study was to test serum fetuin-A concentrations in obese children with NAFLD diagnosed either by ultrasonography or by liver biopsy and to determine its applicability as predictive tool in pediatric NAFLD.
Metabolic parameters and fetuin-A levels were investigated in 81 obese children with NAFLD diagnosed by biopsy, 79 obese children with NAFLD defined by liver ultrasonography and 23 lean subjects. Serum fetuin-A correlated significantly with age, waist circumference, systolic blood pressure, fasting insulin and 2-h postload insulin during OGTT, HOMA-IR, ISI, CRP, and apo B levels. Obese children with NAFLD detected by ultrasonography had significantly higher fetuin-A levels compared to those with normal liver. In obese children who underwent liver biopsy, no significant differences were detected in fetuin-A levels between subject with nonalcoholic steatohepatitis and those with simple steatosis. Fetuin-A was not different between obese and lean children.
Fetuin-A is not related with the degree of liver damage in obese children with NAFLD and its routine measurement as marker of liver disease severity is therefore not recommended.
胎球蛋白-A已被提议作为肥胖相关非酒精性脂肪性肝病(NAFLD)成人患者肝损伤的标志物。本研究旨在检测经超声检查或肝活检诊断为NAFLD的肥胖儿童的血清胎球蛋白-A浓度,并确定其作为儿童NAFLD预测工具的适用性。
对81例经活检诊断为NAFLD的肥胖儿童、79例经肝脏超声检查确诊为NAFLD的肥胖儿童和23例瘦儿童的代谢参数和胎球蛋白-A水平进行了研究。血清胎球蛋白-A与年龄、腰围、收缩压、空腹胰岛素、口服葡萄糖耐量试验(OGTT)期间的2小时负荷后胰岛素、稳态模型评估胰岛素抵抗(HOMA-IR)、胰岛素敏感指数(ISI)、C反应蛋白(CRP)和载脂蛋白B水平显著相关。与肝脏正常的肥胖儿童相比,经超声检查发现患有NAFLD的肥胖儿童的胎球蛋白-A水平显著更高。在接受肝活检的肥胖儿童中,非酒精性脂肪性肝炎患者与单纯性脂肪变性患者的胎球蛋白-A水平未检测到显著差异。肥胖儿童和瘦儿童的胎球蛋白-A水平无差异。
胎球蛋白-A与患有NAFLD的肥胖儿童的肝损伤程度无关,因此不建议将其常规检测作为肝病严重程度的标志物。