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 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.