Tumor necrosis factor alpha and its soluble receptors in obese children with NAFLD

Purpose: To evaluate the serum levels of tumor necrosis factor (TNF) alpha and its soluble receptors in obese children with nonalcoholic fatty liver disease (NAFLD). Material/methods: Fasting serum levels of TNF alpha and its receptors were determined in 45 consecutive obese children with suspected liver disease and 20 lean controls. The degree of liver steatosis was graded in ultrasound according to Saverymuttu. 1H-MR spectroscopy was performed with 1.5T scanner with PRESS sequence. Results: A fatty liver was confirmed in 32 children by ultrasonography (group I); 16 of them also had increased ALT activity (group Ia - NAFLD). Serum concentrations of TNF alpha and its receptors were significantly higher in obese children with NAFLD compared to controls. Significant correlation was found between ultrasonographic grade of liver steatosis and TNF alpha level but serum level of this adipokine was not significantly different in children with advanced liver steatosis (grade 2-3, n=13) compared to patients with mild steatosis (grade 1, n=19). The ability of TNF alpha and its receptors (R1, R2) to differentiate children with advanced liver steatosis from those with mild steatosis was insignificant. However, the ability of serum TNF alpha to differentiate obese children with liver steatosis from those without steatosis was significant (AUC=0.7448, p=0.0291). Conclusion: Although TNF alpha does not predict advanced liver steatosis, it may be suitable serum marker in predicting liver steatosis in obese children.