11 research outputs found
Plasma N-terminal propeptide of type III procollagen accurately predicts liver fibrosis severity in children with non-alcoholic fatty liver disease
Background & Aims
We examined the diagnostic performance of plasma Nâterminal propeptide of type III procollagen (PIIINP) levels, aspartate aminotransferase to platelet ratio index (APRI) and Fibrosisâ4 (FIBâ4) score for predicting nonâalcoholic steatohepatitis (NASH) and liver fibrosis stage in children/adolescents with nonâalcoholic fatty liver disease (NAFLD).
Methods
We enrolled 204 children/adolescents with biopsyâproven NAFLD at the "Bambino GesĂč" Children's Hospital. We measured plasma PIIINP levels using a commercially available enzymeâlinked immunosorbent assay kit and calculated APRI and FIBâ4 scores using standard methods.
Results
Children with NASH had higher plasma PIIINP levels, APRI and FIBâ4 scores compared with those without NASH (all P < .001). However, PIIINP levels had much better diagnostic performance and accuracy than APRI and FIBâ4 scores for predicting liver fibrosis stage. PIIINP levels correlated with the total NAFLD activity score (NAS) and its constituent components (P < .0001). The risk of either NASH or F â„ 2 fibrosis progressively increased with increasing PIIINP levels (P < .0001), independent of age, gender, adiposity measures, insulin resistance, NAS score and the patatinâlike phospholipase domainâcontaining proteinâ3 rs738409 polymorphism. For every 3.6 ng/mL increase in PIIINP levels, the likelihood of having F â„ 2 fibrosis increased by ~14âfold (adjustedâodds ratio 14.1, 95% CI 5.50â35.8, P < .0001) after adjustment for the aforementioned risk factors. The area under the receiver operating characteristics curve was 0.921 (95% CI 0.87â0.97) for F â„ 2 fibrosis, and 0.993 (95% CI 0.98â1.0) for F3 fibrosis respectively.
Conclusions
Unlike APRI and FIBâ4 scores, plasma PIIINP levels are a promising, nonâinvasive biomarker for diagnosing liver fibrosis stage in children/adolescents with biopsyâproven NAFLD
Higher Levels of Plasma Hyaluronic Acid and N-terminal Propeptide of Type III Procollagen Are Associated With Lower Kidney Function in Children With Non-alcoholic Fatty Liver Disease
NASH, NAFLD, liver fibrosis, CKD, childre
Higher levels of plasma hyaluronic acid and N-terminal propeptide of type III procollagen are associated with lower kidney function in children with non-alcoholic fatty liver disease
Objective: hyaluronic acid (HA) and N-terminal propeptide of type III procollagen (PIIINP) are two non-invasive biomarkers of liver fibrosis in non-alcoholic fatty liver disease (NAFLD). We examined the relationships of plasma levels of HA and PIIINP with kidney function in children with NAFLD.
Methods: plasma HA and PIIINP levels were measured using two commercially available enzyme32 linked immunosorbent assay kits in a cohort of 106 Caucasian overweight or obese children with biopsy-proven NAFLD. Glomerular filtration rate (eGFR) was estimated using the Bedside Schwartz equation. Genotyping for the patatin-like phospholipase domain-containing protein-3 (PNPLA3) rs738409 variant was performed using an allelic discrimination assay.
Results: children with fibrosis F2 had significantly higher plasma PIIINP and HA levels than those with F0 or F1 fibrosis. Liver fibrosis was positively associated with plasma HA and PIIINP, as well as with the presence of the risk allele G of PNPLA3 rs738409 variant, and negatively with eGFR. Moreover, eGFR showed significant inverse associations with HA and PIIINP levels, as well as the presence of G of PNPLA3 rs738409, and liver fibrosis stage. Notably, our multivariable regression models showed that higher plasma PIIINP (standardized beta coefficient: -0.206, p=0.011) and HA levels (standardized beta coefficient: -0.531, p<0.0001) were associated with lower eGFR values, even after adjustment for age, sex, systolic blood pressure, PNPLA3 rs738409 genotype and any stage of liver fibrosis.
Conclusions: higher levels of HA and PIIINP were associated with lower eGFR values in Caucasian children with biopsy-proven NAFLD, independently of PNPLA3 rs738409 genotype and other potential confounding factors
ÎČ-Klotho gene variation is associated with liver damage in children with NAFLD
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in adults and children. Along with obesity, diabetes and insulin resistance, genetic factors strongly impact on NAFLD development and progression. Dysregulated bile acid metabolism and the fibroblast growth factor 19 (FGF19) pathway play a pivotal role in NAFLD pathogenesis. However, it remains to be defined the mechanism through which the FGF19 receptor system is associated with liver damage in NAFLD