Leptin, free leptin index, insulin resistance and liver fibrosis in children with non-alcoholic fatty liver disease

Valerio Nobili, Melania Manco, Paolo Ciampalini, Vincenzo Diciommo, Rita Devito, Fiorella Piemonte, Donatella Comparcola, Roberto Guidi, Matilde Marcellini

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Objective: Prevalence of non-alcoholic fatty liver disease (NAFLD) among children is increasing dramatically. It is unclear why some patients develop steatohepatitis (NASH), fibrosis and cirrhosis from steatosis, and others do not. A role for leptin has been claimed. This study aims to evaluate the relationship between leptin, insulin resistance (IR) and NAFLD in children. Design and methods: In 72 biopsy-proven NAFLD children (aged 9-18 years; 51M/21F), fasting leptin and its soluble receptor (sOB-R) were measured; free leptin index (FLI) was calculated as leptin/sOB-R; IR was estimated by homeostasis model assessment (HOMA-IR) and insulin sensitivity index (ISI-comp); glucose tolerance by oral glucose tolerance test (OGTT). Percentage of total body fat (TBF) by dual-energy X-ray absorptiometry (DXA) was available in 65 patients. Results: Prevalence of diabetes, impaired fasting and/or after load glucose tolerance was 11%. HOMA-IR and ISI-comp values were 2.55 ± 1.39 and 4.4 ± 2. NASH was diagnosed in 38 and simple steatosis in 25 children; diagnosis was indeterminate in 29 children. Increased fibrosis, mostly of mild severity, was observed in 41 patients. Median NAFLD activity (NAS) score was 3.42 ± 1.60. According to histology, levels of leptin and FLI increased as steatosis (leptin from 11.9 ± 6.3 in score 1 to 17.4 ± 6.9 in score 2 (P=0.01) and 22.2±6.8 ng/ml in score 3 (P0=0.6,0.4 and 0.6 respectively; for all Po=0.4, P0=0.5, P0=0.5, P

Original languageEnglish
Pages (from-to)735-743
Number of pages9
JournalEuropean Journal of Endocrinology
Issue number5
Publication statusPublished - Nov 2006

ASJC Scopus subject areas

  • Endocrinology


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