To examine the role of metabolic, hormonal, oxidative, and inflammatory factors in pediatric obesity-related liver disease. Study design: In 50 obese children (age 7 to 14 years) with (n = 20, group 1) or without (n =...To examine the role of metabolic, hormonal, oxidative, and inflammatory factors in pediatric obesity-related liver disease. Study design: In 50 obese children (age 7 to 14 years) with (n = 20, group 1) or without (n = 30, group 2) hypertransaminasemia and ultrasonographic liver brightness, we studied insulin resistance (fasting glucose/insulin ratio [FGIR]- ) and serum levels of leptin, iron, transferrin, ferritin, C-reactive protein (CRP), white blood cell (WBC) count, tumor necrosis factor (TNF)- α , interleukin (IL)- 6, C282Y and H63D mutations, and erythrocytic glutathione peroxidase (GPX) activity. Results: FGIR (6.7 ± 4.1 vs 9.2 ± 5.2; P = .02), serum ferritin (88.8 ± 36.0 vs 39.9 ± 24.0 ng/mL; P = .0001), serum CRP (5.4 ± 6.0 vs 1.1 ± 1.6 mg/dL; P = 0.004), and GPX (8.4 ± 0.9 vs 5.0 ± 0.5 U/g Hb; P = .05) were significantly higher and more frequently deranged in group 1 than in group 2. FGIR, ferritin, and CRP values were simultaneously deranged in 41% of the group 1 patients and in none of the group 2 patients (P = .098). Serum leptin, iron, and transferrin, WBC, TNF- α , IL- 6, and C282Y and H63D mutations were similar in the 2 groups. Conclusions: Insulin resistance, oxidative stress, and low-grade systemic inflammatory status are implicated in pediatric obesity-related liver disease. These findings may be useful in planning pathophysiologically based therapeutic trials for hepatopathic obese children who are unable to follow hypocaloric diets.展开更多
文摘To examine the role of metabolic, hormonal, oxidative, and inflammatory factors in pediatric obesity-related liver disease. Study design: In 50 obese children (age 7 to 14 years) with (n = 20, group 1) or without (n = 30, group 2) hypertransaminasemia and ultrasonographic liver brightness, we studied insulin resistance (fasting glucose/insulin ratio [FGIR]- ) and serum levels of leptin, iron, transferrin, ferritin, C-reactive protein (CRP), white blood cell (WBC) count, tumor necrosis factor (TNF)- α , interleukin (IL)- 6, C282Y and H63D mutations, and erythrocytic glutathione peroxidase (GPX) activity. Results: FGIR (6.7 ± 4.1 vs 9.2 ± 5.2; P = .02), serum ferritin (88.8 ± 36.0 vs 39.9 ± 24.0 ng/mL; P = .0001), serum CRP (5.4 ± 6.0 vs 1.1 ± 1.6 mg/dL; P = 0.004), and GPX (8.4 ± 0.9 vs 5.0 ± 0.5 U/g Hb; P = .05) were significantly higher and more frequently deranged in group 1 than in group 2. FGIR, ferritin, and CRP values were simultaneously deranged in 41% of the group 1 patients and in none of the group 2 patients (P = .098). Serum leptin, iron, and transferrin, WBC, TNF- α , IL- 6, and C282Y and H63D mutations were similar in the 2 groups. Conclusions: Insulin resistance, oxidative stress, and low-grade systemic inflammatory status are implicated in pediatric obesity-related liver disease. These findings may be useful in planning pathophysiologically based therapeutic trials for hepatopathic obese children who are unable to follow hypocaloric diets.
