Obesity in children is associated with high risk for development and progression of nonalcoholic fatty liver disease (NAFLD). NAFLD has common pathogenetic mechanisms with sarcopenic obesity (SO), in the development of which such myokines as fibroblast growth factor 21 (FGF-21) and irisin play an important role. The study of their secretion peculiarities is relevant to the prospects of using myokines as diagnostic markers or indicators for drug therapy and physical activity control as well as in the development of target therapy for NAFLD. The connection between NAFLD and SO and changes in myokine profile in children is an understudied issue. The purpose of this research was to determine differences between groups of pediatric patients with the presence v. those with the absence of NAFLD in constitutional-exogenous obesity in myokine and SO levels. Methods used: a single-stage comparative single-center uncontrolled study of 95 children aged 12 to 18 y/o with constitutional-exogenous obesity: body mass index (BMI) standard deviation score (SDS)≥+2.0. Results: NAFLD was detected in 48% (n=50/95) [95% CI (42; 63)] of whom steatohepatitis was detected in 40% (n=20/50) [95% CI (26; 55)]. SO was detected in 96% (n=48/50) [95% CI (86; 99)] with NAFLD including children with steatohepatitis (n=20). The combination of SO with elevated FRF-21 levels and decreased irisin was associated with NAFLD (AUC=0.761, [95% CI (0.65; 0.87)]). The SO frequency was statistically significantly higher in NAFLD than in the SO absence (p<0.001). The predictive ability of the SO presence in relation to the detection of NAFLD was found to be high (PCPR=96%, [95% CI (88; 99)]). FRF-21 values above 60 pg/mL (AUC=0.689, [95% CI (0.57; 0.81)]) and irisin values below 7.86 μg/mL (AUC=0.703, 95% CI (0.58; 0.82)]) were associated with the presence of NAFLD. When comparing operational characteristics, no differences were found for AUC value while the best performance was demonstrated by regression model and cut-off point of irisin equal to 7.86 μg/mL. Conclusion: SO combined with changes in myokine profile is associated with NAFLD. Identification of the main factors influencing the NAFLD development in childhood is crucial in preventing the progression of liver damage.
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