Multiple gut-liver axis abnormalities in children with obesity with and without hepatic involvement

Autor(en)
Salvatore Guercio Nuzio, Martina Di Stasi, Luca Pierri, J Troisi, Marco Poeta, Antonella Bisogno, Federica Belmonte, Marina Tripodi, D Di Salvio, Grazia Massa, Riccardo Savastano, Pierpaolo Cavallo, Massimo Boffardi, D Ziegenhardt, I Bergheim, C Mandato, P Vajro
Abstrakt

BACKGROUND: Gut-liver axis (GLA) dysfunction appears to play a role in obesity and obesity-related hepatic complications.

OBJECTIVES: This study sought to concurrently explore several GLA components in a paediatric obese population with/without liver disease.

METHODS: Thirty-two children (mean age 11.2 years) were enrolled: nine controls with normal weight and 23 patients with obesity (OB+). Of the 23 patients OB(+), 12 had not steatosis (ST-), and 11 had steatosis (ST+) (associated [n = 8] or not [n = 3] with hypertransaminasaemia [ALT +/-]). Subjects were characterized by using auxologic, ultrasonographic and laboratory parameters. A glucose hydrogen breath test was performed to test for small intestinal bacterial overgrowth, a urinary lactulose/mannitol ratio (LMR) was obtained to assess intestinal permeability, and tests for transaminases, blood endogenous ethanol, endotoxin and faecal calprotectin were also conducted.

RESULTS: Eleven out of 23 patients OB(+) (p < 0.05) exhibited pathological (>90th percentile of the control group values) LMR, with values paralleling the grade of liver involvement (normal weight < OB[+] < OB[+]ST[+]ALT[-] < OB[+)]ST[+]ALT[+] [p < 0.05]). LMR significantly correlated with ethanolaemia (r = 0.38, p = 0.05) and endotoxaemia (r = 0.48, p = 0.015) concentrations. Increased permeability was a risk factor for the development of steatosis (p < 0.002). SIBO was present only in patients with obesity. Faecal calprotectin concentrations were within normal limits in all subjects.

CONCLUSIONS: Increased permeability, endogenous ethanol and systemic endotoxin concentrations reflect some GLA dysfunction in obesity and its hepatic complications. Pending further results to establish their potential causative roles, the modulation of the GLA appears to represent a possible target for the prevention and treatment of these conditions.

Organisation(en)
Externe Organisation(en)
Università degli Studi di Salerno, Laboratory of Metabolomics Theoreo, Azienda Ospedaliera Universitaria OO.RR. San Giovanni die Dio Ruggi dÀragona, Friedrich-Schiller-Universität Jena, AORN Santobono-Pausilipon, European Laboratory for Food Induced Intestinal Disease (ELFID), Naples, Italy.
Journal
Pediatric Obesity
Band
12
Seiten
446-452
Anzahl der Seiten
7
ISSN
2047-6302
DOI
https://doi.org/10.1111/ijpo.12164
Publikationsdatum
12-2017
Peer-reviewed
Ja
ÖFOS 2012
303009 Ernährungswissenschaften
Schlagwörter
Link zum Portal
https://ucris.univie.ac.at/portal/de/publications/multiple-gutliver-axis-abnormalities-in-children-with-obesity-with-and-without-hepatic-involvement(f34ccbe0-0ff2-47e2-9baa-c25f0cf947a9).html