Metabolic, hormonal, oxidative, and inflammatory factors in pediatric obesity-related liver disease

Objective 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 scrum levels of leptin, iron, transferrin, ferritin, C-reactive protein white blood cell (WBC) count, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, C282Y and II63D peroxidase (GPX) activity. Results FGIR (6.7 +/- 4.1 vs 9.2 +/- 5.2: P = .02), serum ferritin (88.8 +/- 30.0 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 IIb: 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-alpha, IL-6, and C282Y and II63D 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.