ESPE Abstracts (2015) 84 P-2-362

Nonalcoholic Fatty Liver Disease and Intestinal Inflammation in Obese Children

Zehra Yavas Abalia, Seha Saygilib, Tulin Ozdenb, Serdar Cantezc, Firdevs Basa, Vildan Ertekinc, Ruveyde Bundaka, Ozlem Durmazc & Feyza Darendelilera


aDepartment of Pediatric Endocrinology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey; bDepartment of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey; cDepartment of Pediatric Gastroenterology, Hepatology and Nutrition, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey


Background: The prevelance of pediatric obesity is increasing in childhood. Nonalcoholic fatty liver disease (NAFLD) is frequently associated with obesity, insulin resistance (IR), diabetes, and hypertriglyceridemia. Gut microbiota was suggested to play a role in both etiology of NAFLD and also progression to steatohepatitis. Feacal calprotectin (FCP) is a noninvasive marker of intestinal inflammation.

Objective and hypotheses: To evaluate FCP and its association with IR and NAFLD in obese children.

Method: The study included 63 obese children (33F), with a mean age of 12.4±3.1 years (range 6.0–18.0). Anthropometric measurements were obtained, BMI SDS was calculated and BMI >95% was defined as obesity. IR was expressed as HOMA-IR index from fasting glucose and insulin concentrations. FCP was measured by an ELISA test. Values >50 μg/g indicate intestinal inflammation and this level was accepted as the cut-off for FCP. NAFLD diagnosis was made by ultrasound. The patients were divided into two groups according to liver echogenicity as normal or NAFLD.

Results: Age, BMI SDS, HOMA-IR, and FCP levels of patients with normal liver echogenicity and NAFLD are seen in the Table. There was a positive correlation between BMI SDS and HOMA-IR (r=0.274, P=0.045) but there was no correlation between FCP and BMI SDS or FCP and HOMA-IR. In high FCP (>50 μg/g) patients, NAFLD was seen in 92.6% while in patients with normal FCP, NAFLD was seen in 66.6% (χ2=6.000, P=0.014).

Normal (n=14)NAFLD (n=49)
Age (years)13.3±3.512.1±2.9
BMI SDS2.6±0.52.6±0.7
HOMA-IR4.5±2.44.4±2.0
FCP (μg/g)*31.0±21.575.3±71.7
Mean±S.D. are given. *P=0.020, Mann–Whitney U test.

Conclusion: FCP could be a helpful method during the follow up of obese children with NAFLD.

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