Serum Levels of CK18 M30 and Leptin Are Useful Predictors of Steatohepatitis and Fibrosis in Paediatric NAFLD

Emer Fitzpatrick, Ragai R Mitry, Alberto Quaglia, Munther J Hussain, Ruth DeBruyne, Anil Dhawan

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97 Citations (Scopus)

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 = F2) could be differentiated from no/minimal fibrosis (= 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.
Original languageEnglish
Pages (from-to)500 - 506
Number of pages7
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume51
Issue number4
DOIs
Publication statusPublished - Oct 2010

Keywords

  • Adiponectin
  • Biological Markers
  • C-Reactive Protein
  • Child
  • Colorimetry
  • Enzyme-Linked Immunosorbent Assay
  • Fatty Liver
  • Female
  • Fibrosis
  • Humans
  • Hyaluronic Acid
  • Keratin-18
  • Leptin
  • Male
  • Predictive Value of Tests
  • Severity of Illness Index

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