Exploring the Role of Serum Osteonectin and Hsp27 in Pediatric MAFLD Diagnosis and Cardiometabolic Health.

BACKGROUND: Childhood obesity is one of the major challenges of public health policies. The problem of fatty liver in childhood, known as MAFLD (metabolic dysfunction-associated fatty liver disease), is of particular interest as the gold standard diagnosis technique is invasive (liver biopsy). Hence, efforts are made to discover more specific biomarkers for the MAFLD signature. Therefore, the aim of the study was to evaluate Osteonectin and Hsp27 as biomarkers for MAFLD diagnosis and to assess their links with auxological and biochemical profiles of overweight and obese pediatric subjects. METHODS: A cross-sectional study in which we (re)analyzed data from the MR PONy cohort comprising 71 pediatric subjects. Auxological data, liver ultrasonography and biochemical serum profile were recorded. Lipid-derived indices and body composition indices were calculated. Nevertheless, serum Osteonectin and Hsp27 levels were assessed using an ELISA approach. RESULTS: MAFLD prevalence was 40.8%. Higher Osteonectin levels were noted in MAFLD subjects versus non-MAFLD subjects and in dyslipidemic children regardless of their liver function status. Lipid-derived indices had good diagnostic capacity for MAFLD. CONCLUSIONS: We confirm Osteonectin as a MAFLD diagnosis biomarker in children. Also, lipid-derived indices are useful as metabolic-associated organ impairment markers in children even before the onset of obesity.

Endocan and Lumican in Relation to Cardiometabolic Risk in a Pediatric Overweight and Obese Cohort: A Cross-Sectional Study.

The aim of the study was to evaluate serum Endocan and Lumican levels as biomarkers for pediatric Nonalcoholic Fatty Liver Disease (NAFLD) and to explore their associations with pediatric cardiometabolic risk factors. We conducted a cross-sectional study on 68 pediatric obese and overweight (O&O) patients. Ten healthy controls were recruited. Serum Lumican and Endocan levels were analyzed using ELISA kits. O&O patients had lower levels of Endocan compared to healthy controls (p < 0.001). There were no differences between serum Endocan levels in O&O patients with NAFLD and those without (p = 0.53). Patients considered having Nonalcoholic Steatohepatitis (NASH) had lower Endocan levels compared to O&O patients without NASH (p = 0.026). Patients with metabolic syndrome had lower levels of Endocan (p = 0.003). There were no significant differences between serum Lumican levels in O&O children compared to healthy controls. Lumican levels were higher in patients with hypertension (p = 0.04). In O&O patients, Lumican levels were negatively correlated with Endocan levels (r = -0.37, p = 0.002). Endocan seems a promising biomarker for the evaluation of pediatric NASH. Lumican was not confirmed as a biomarker for NAFLD in our cohort but was associated with higher arterial pressure. Low Endocan levels are accompanied by high serum Lumican levels, and this could be an early signature of cardiometabolic risk.

Circulating Hsp90 Isoform Levels in Overweight and Obese Children and the Relation to Nonalcoholic Fatty Liver Disease: Results from a Cross-Sectional Study.

BACKGROUND: Obesity prevalence is increasing in children. It is associated with various comorbidities including nonalcoholic fatty liver disease (NAFLD). Hsp90 isoforms were identified in previous proteomic studies as potential biomarkers for NAFLD. The aim of the study was to analyze circulating levels of Hsp90α and Hsp90ß in overweight and obese children. In addition, Hsp90α and Hsp90ß were evaluated as biomarkers for NAFLD in overweight and obese children. METHODS: 68 overweight and obese children and ten age- and gender-matched controls were recruited. Hsp90α and Hsp90ß levels were analyzed from serum in both controls and overweight and obese children by ELISA. RESULTS: Serum Hsp90ß and total Hsp90 levels were statistically significantly higher in overweight and obese children compared to controls. On the contrary, there was no difference in Hsp90α levels between overweight and obese children and healthy controls. Hsp90 isoforms had different expression in NAFLD patients. Hsp90ß levels were higher in overweight and obese NAFLD patients while Hsp90α levels were lower. Hsp90α to Hsp90ß ratio had better accuracy for NAFLD diagnosis in obese and overweight patients compared to individual biomarkers. CONCLUSION: Hsp90 isoforms were confirmed on an independent cohort as biomarkers for NAFLD in overweight and obese children. In these patients, it seems to be more useful to separately analyze Hsp90 isoforms rather than total Hsp90 as the isoforms have greater discriminative capacity.

Candidate proteomic biomarkers for non-alcoholic fatty liver disease (steatosis and non-alcoholic steatohepatitis) discovered with mass-spectrometry: a systematic review.

CONTEXT: Non-alcoholic fatty liver disease (NAFLD) is characterized by lipid accumulation in the liver which is accompanied by a series of metabolic deregulations. There are sustained research efforts focusing upon biomarker discovery for NAFLD diagnosis and its prognosis in order investigate and follow-up patients as minimally invasive as possible. OBJECTIVE: The objective of this study is to critically review proteomic studies that used mass spectrometry techniques and summarize relevant proteomic NAFLD candidate biomarkers. METHODS: Medline and Embase databases were searched from inception to December 2014. RESULTS: A final number of 22 records were included that identified 251 candidate proteomic biomarkers. Thirty-three biomarkers were confirmed - 14 were found in liver samples, 21 in serum samples, and two from both serum and liver samples. CONCLUSION: Some of the biomarkers identified have already been extensively studied regarding their diagnostic and prognostic capacity. However, there are also more potential biomarkers that still need to be addressed in future studies.

Ultrasound diagnosis in two cases of severe craniofacial anomalies.

Holoprosencephaly (HPE) is a rare anomaly of the brain consisting of an absent or incomplete separation of the forebrain in early gestation. We present 2 variants of HPE, diagnosed by ultrasound, which combined with the clinical features led to HPE subtypes differentiation.

Preterm screening by transfontanelar ultrasound - results of a 5 years cohort study.

OBJECTIVES: Intracranial hemorrhages (ICH) might be the cause of significant psycho-motor or cognitive impairment in preterm babies. A 5 year cohort study performed in the IOMC was aimed at determining the prevalence and proportion of the main types of ICH diagnosed by transfontanelar (TF) ultrasound among admitted preterms, along with the neuro-developmental effects on a 12 month follow-up period. MATERIAL AND METHODS: In the above mentioned period all enrolled newborns were examined by TF ultrasound according to a common standardized protocol. The 4 grade Papile ICH classification was used for all examined subjects. In order to determine the potential neurological sequels we performed a 12 month neurological follow-up of all 292 patients in the study group. RESULTS: The prevalence of all types ICH diagnosed by systematic TF ultrasound was 20.4 %. The most prevalent type of ICH was peri-intraventricular: 40% grade I and 33 % grade II, with no major neurological sequels For both the correlation to the neurological outcome was statistically significant (p < 0.05). Severe neurological sequels were associated with grade III and IV, but the correlation was found to be statistically significant (p < 0.05) only for grade IV hemorrhages. A severe neurological outcome was of statistical significance only for the cerebellar hemorrhage outcome, although a similar pattern was also observed for the thalamic hemorrhages. CONCLUSION: Systematic TF screenings for preterm is useful for early diagnosis and staging which might improve the management of rehabilitation therapies, and provide appropriate information on the disease outcome as well as influencing the quality of parental counseling.