ESPE Abstracts

Background: Fetuin A is a hepatokine known as a natural inhibitor of the insulin receptor tyrosine kinase and is associated with insulin resistance and nonalcoholic fatty liver disease (NAFLD). Studies on adults provided conflicting results regarding the link between fetuin A and the severity of liver damage in NAFLD. Data on children are limited.

Objective: To investigate the relationship between fetuin A, metabolic parameters, and NAFLD in obese children.

Methods: 118 obese subjects (48F/70M), aged 9.3±2.4 years, were studied. Anthropometry, OGTT, biochemical measurements, and fetuin A serum levels were assessed. In 19 children the presence of NAFLD was investigated by ultrasonography (US). 7/19 children had a normal liver US (group 1), whereas 12/19 were diagnosed as NAFLD (group 2). Ninety-nine children underwent liver biopsy to assess the presence of NASH: 14 were diagnosed as ‘NASH’ (group 3) and 85 as ‘not NASH’ (group 4). Differences between groups were assessed by Mann–Whitney U-test.

Results: Fetuin A levels were related to age (r=0.25, P<0.01), waist circumference (WC) (r=0.2, P<0.05) systolic blood pressure (r=0.2, P<0.05), apolipoprotein B (r=0.275, P<0.01), fasting plasma glucose (r=0.2, P<0.05) and insulin levels (r=0.3, P<0.005), OGTT mean insulin (r=0.26, P<0.05), 2 h postload insulin (r=0.26, P<0.01), HOMA-IR (r=0.3, P<0.01), and ISI (r=−0.3, P<0.01). Stepwise regression analysis revealed that among age, BMI SDS and WC, fetuin A was the major predictors of 2 h postload insulin levels (adj R² 0.105). Group 2 tended to have significantly higher levels of fetuin A (723.2±102.6 μg/ml) than group 1 (641.1±81.4 μg/ml) (P=0.056). No significant differences between groups were found in age and BMI. Among children who underwent liver biopsy no significant difference between groups 3 and 4 was found in fetuin A serum levels.

Conclusion: Fetuin A may represent a biomarker of NAFLD in obese children, though not related to the severity of the disease.