Serum Visfatin Level as a Biomarker for Non-alcoholic Fatty Liver Disease in Obese Children and Adolescents

Marwa Ahmad Khalaf Ali


SUMMARY N on-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. It is one of the features of metabolic syndrome in obese children and adolescents. Liver biopsy, which is the gold standard for diagnosing NAFLD is an invasive procedure with potential adverse effects. Visfatin is a novel adipokine originally described to be produced predominantly by visceral fat tissue. It also synthesized by bone marrow cells, activated lymphocytes, liver cells, and skeletal muscle cells. FibroScan, or transient elastography (TE), non-invasively assesses liver fibrosis and presents comparable performance to liver biopsy to predict liver-related outcomes in patients with chronic liver diseases. Therefore, we measured visfatin levels in obese children and adolescents as a potential marker for NAFLD and assess its relation to liver stiffness assessed by transient elastography (Fibroscan). This study included 80 children and adolescents with simple obesity (42 males and 38 females) recruited from the regular attendants of the Pediatric Obesity Clinic, Pediatric Hospital, Ain Shams University. Patients were compared with 40 age- and sex-matched healthy subjects (26 males and 14 females) enrolled as controls. The mean age of obese patients was 9.0 ± 3.1 years (range: 3-16 years) while that of controls was 9.9 ± 3.2 years (range: 5-14 years). All included patients were subjected to detailed medical history and thorough clinical examination with special emphasis on blood pressure and auxological measures (BMI and waist/hip ratio). Abdominal ultrasound was done for assessment of the liver size in cm, echogenicity, hepatic vasculature and presence of focal lesion or intrahepatic biliary radicles dilatation. Liver stiffness measurements were done for all patients using FibroScan. CAP, a novel physical parameter based on the properties of ultrasonic signals acquired by the Fibroscan machine was assessed. Laboratory investigations included fasting lipid profile, fasting blood glucose and insulin level, liver and kidney functions and coagulation profile. Serum vsiaftin levels were measured by enzyme linked immunosorbent assay (ELISA). In the current work, weight SDS, BMI SDS, waist and hip circumference SDS as well as waist/hip ratio SDS were higher among patients than controls. As regards laboratory data among obese patients, 16 out of 80 (20%) patients had elevated ALT >42 IU/L and 5 (6.3%) patients had insulin resistance (HOMA IR ≥3.0). The highest incidence of dyslipidemia was observed according to HDL cholesterol <45 mg/dL where 47/80 (58.8%) patients had dyslipidemia.

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Other Titles مستوى الفسفاتين فى الدم كمؤشر لمرض الكبد الدهني في الأطفال والمراهقين الذين يعانون من السمنة
Issue Date 2017

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