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J Pediatr Gastroenterol Nutr. 2010 Oct;51(4):500-6. doi: 10.1097/MPG.0b013e3181e376be.

Serum levels of CK18 M30 and leptin are useful predictors of steatohepatitis and fibrosis in paediatric NAFLD.

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  • 1Paediatric Liver, GI, and Nutrition Centre, King's College London School of Medicine at King's College Hospital, London, UK. emer.fitzpatrick@kcl.ac.uk

Abstract

BACKGROUND:

With the alarming growth in prevalence of paediatric nonalcoholic fatty liver disease (NAFLD), there is a need for noninvasive methods of stratifying disease severity. Our aim was to evaluate a combination of serum biomarkers as a measure of disease activity in paediatric NAFLD.

PATIENTS AND METHODS:

Forty-five children with biopsy-proven NAFLD were enrolled. Caspase-cleaved CK18 fragments (CK18 M30), hyaluronic acid, leptin, and adiponectin were measured in serum using enzyme-linked immunosorbent assays and high-sensitivity C-reactive protein using a colorimetric assay.

RESULTS:

Median age was 12.7 years (55% boys). Median body mass index z score was 1.7. CK18 M30 levels were significantly higher in patients with NAFLD versus controls, median 288 IU/L versus 172 IU/L (P < 0.001), and in those with steatohepatitis, median 347 IU/L versus simple steatosis (NAFLD activity score < 3), median 191 IU/L (P = 0.006). Significant fibrosis (≥F2) could be differentiated from no/minimal fibrosis (<F2), median 393 IU/L versus 243 IU/L (P = 0.03). Leptin could distinguish <F2 from ≥F2; 28.9 ng/mL versus 70.1 ng/mL (P = 0.037). Adiponectin, hyaluronic acid, and high-sensitivity C-reactive protein did not achieve significance in predicting steatohepatitis nor significant fibrosis.

CONCLUSIONS:

The present study combines use of markers for different processes in the development of steatohepatitis. Serum biomarkers, especially CK18 M30, are useful in stratifying disease severity in paediatric NAFLD.

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PMID:
20808246
[PubMed - indexed for MEDLINE]
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