ESPE Abstracts

Background: Non-alcoholic fatty liver disease (NAFLD) represents a spectrum of clinicopathological conditions frequently discovered in obese patients and characterized by multifactorial pathogenesis. Hypoadiponectinaemia and higher interleukin (IL)-6 levels has been related to NAFLD, even if some contradictory findings have emphasized our incomplete understanding of the role of the cytokines in NAFLD.

Objective and hypotheses: To investigate the relationship between adiponectin and IL-6 in the hepatic steatosis (HS) and insulin resistance mechanisms in a cohort of obese children.

Method: Thirty-five children with simple obesity, considered as subjects with a body mass index (BMI) over the 95th percentile obese according to Italian centiles, and 29 controls were recruited. Serum adiponectin and IL-6 levels were determined and an oral glucose tolerance test and a hepatic ultrasound were performed in the two groups. The Homeostatic model assessment of insulin resistance (HOMA-IR) and the whole body insulin sensitivity index (WBISI) were calculated.

Results: IL-6 serum levels were significantly higher (P=0.03) and serum adiponectin levels were significantly lower (P=0.04) in the obese children than in the controls. The serum adiponectin level was significantly inversely correlated with BMI in both groups (obese P=0.01; controls P=0.04). The BMI values were significantly higher (P=0.0002), and adiponectin levels were significantly lower (P=0.01) in obese children with hepatic steatosis than in those without, whereas IL-6 serum levels were not statistically different. HOMA-IR and WBISI were significantly correlated with adiponectin, but not with BMI, HS or IL-6.

Conclusion: Hypoadiponectinaemia plays a more precocious role than IL-6 in the development of hepatic steatosis and insulin resistance in obese children.