INTERLEUKIN 10, THYROID STATUS AND FERRITIN ARE NON-INVASIVE PROGNOSTIC BIOMARKERS FOR DIAGNOSIS OF FATTY LIVER DISEASE IN CHILDREN

Background: Non-alcoholic fatty liver disease (NAFLD) is one cause of a fatty liver, occurring due to deposition of fat (steatosis) in the liver. NAFLD in fact covers a histological spectrum ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), advanced fibrosis, and cirrhosis. Survival is lower in patients with NASH based on the findings from long-term longitudinal studies. It is therefore imperative to distinguish simple steatosis from NASH in order to provide risk stratification and intervention slowing down disease progression for patients with the latter condition.

Aim of the Study: The present study aimed to find relevant non-invasive prognostic markers which might help minimize the frequency of liver biopsies to evaluate disease progression.

Patients and Methods: This case control study enrolled 50 child patients with NAFLD diagnosed by liver enzymes and hepatic ultrasonography. They were 30 males and 20 females (mean age 11±2.68 years). The control group included 50 healthy children, they were 19 males and 31 females (mean age 9.48±3.22 years). Results: In this study, higher BMI, mean fasting plasma glucose, total cholesterol, LDL, triglycerides, CRP, total bilirubin, serum ALT, AST, GGT, iron, Ferritin, IL10 and APRI score along with lower HDL, albumin, TSH, free T3 and free T4, were all associated with NAFLD. While, Patients with grade 2 NAFLD had lower TSH, IL10 and higher Iron, Ferritin than grade 1 NAFLD patients.

Conclusion: Decreased TSH, free T3 and free T4 and IL10 along with increased iron and Ferritin may all serve as non-invasive prognostic biomarkers for diagnosis of NAFLD grades.