The Contribution of the Adipose Tissue-Liver Axis in Pediatric Patients with Nonalcoholic Fatty Liver Disease after Laparoscopic Sleeve Gastrectomy.

Abstract

OBJECTIVE:

To evaluate the histopathologic modifications in liver and visceral adipose tissue (VAT), and to correlate these changes with clinical measures, adipokine production, and proinflammatory cytokines in a population of adolescents with obesity with nonalcoholic fatty liver disease (NAFLD) who underwent laparoscopic sleeve gastrectomy (LSG).

STUDY DESIGN:

Twenty adolescents with obesity who underwent LSG and with biopsy-proven NAFLD were included. Patients underwent clinical evaluation and blood tests at baseline and 1 year after the surgical procedure. Liver and VAT specimens were processed for routine histology, immunohistochemistry, and immunofluorescence.

RESULTS:

In adolescents with obesity and NAFLD, hepatic histologic alterations were uncorrelated with VAT inflammation. LSG induced in both liver and VAT tissue histopathology amelioration and macrophage profile modification that were correlated with body mass index and improvement in insulin resistance. The adipokine profile in liver and VAT was associated with weight loss and histologic improvement after LSG. Serum proinflammatory cytokines were correlated with liver and VAT histopathology and IL-1β and IL-6 levels were independently predicted by liver necroinflammatory grade.

CONCLUSIONS:

This study suggests a unique adipose tissue/fatty liver crosstalk in pediatric patients. LSG induces a similar pattern of histologic improvement in the liver and in VAT. Besides VAT, our results strengthen the role of the liver in adipocytokine production and its contribution to systemic inflammation in pediatric patients with NAFLD.

• Authors: Antonio Franchitto, Guido Carpino, Anna Alisi, Francesco De Peppo, Diletta Overi, Cristiano De Stefanis, Ilaria Romito, Rita De Vito, Romina Caccamo, Battaglia Sonia, Salvatori Alessandra, Antonella Mosca, Arianna Alterio, Paolo Onori, Eugenio Gaudio, Valerio Nobili
• Journal: The Journal of pediatrics (J Pediatr) Vol. 216 Pg. 117-127.e2 (01 2020) ISSN: 1097-6833 [Electronic] United States
• PMID: 31526528 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Chemical References

• Adipokines

Topics

• Adipokines (biosynthesis)
• Adolescent
• Correlation of Data
• Female
• Gastrectomy (methods)
• Humans
• Intra-Abdominal Fat (metabolism, pathology)
• Laparoscopy
• Liver (metabolism, pathology)
• Macrophages
• Male
• Non-alcoholic Fatty Liver Disease (complications, pathology)
• Pediatric Obesity (complications, surgery)
• Prospective Studies