Evaluation Of LECT2 And PEDF In Obese Children With Metabolically Associated Fatty Liver Disease

Background and objectiveMetabolic associated fatty liver disease(Metabolic associated fatty liver disease,MAFLD)is currently the most common sub-type of fatty liver disease in children.MAFLD has a long history of influence on the health of children and adolescents.In the early stage of the disease,there are no clinical symptoms,but with the progress of the disease,more and more complications such as hyperlipidemia,hypertension,diabetes,cardiovascular disease,etc.,have attracted people’s attention.As the initial stage of disease development,MAFLD is easy to further develop into steatohepatitis if it is not controlled by appropriate means.In severe cases,the probability of cirrhosis and liver cancer within 10 years is as high as 15%-25%.Liver biopsy and other non-invasive diagnostic methods are restricted to a certain extent,which is not conducive to clinical application.Therefore,this study aims to seek a simpler and more effective method for early diagnosis of children’s MAFLD,as well as to assess the severity of the disease and control the further development of the disease.MethodsIn this study,children treated in the pediatric Department of Affiliated Hospital of Nantong University from October 2021 to December 2022 were selected and divided into three groups according to relevant guidelines: simple obesity group(36 males and24 females),MAFL group(29 males and 11 females)and MASH group(26 males and12 females).Healthy children were used as control group(39 males and 26 females).All clinical information was collected from the two groups,and gender,age,BMI,FBG,FINS,C-peptide,ALT,ALT,AST,γ-GGT,TG,TC,LDL-C,HDL-C,SUA,PLT,etc.;Serum LECT2 and PEDF levels in each group were compared by enzyme-linked immunosorbent assay.To compare whether the differences in LECT2 and PEDF levels between different groups were statistically significant.The diagnostic assessment value of using a single LECT2,PEDF,and NAFLD liver fat score in children with MAFLD was evaluated by ROC curve,and further,the three LECT2,PEDF,and NAFLD liver fat scores were combined in two to compare their diagnostic assessment value.Results1.The BMI of the simple obesity group,MAFL group,and MASH group were significantly higher than that of the healthy control children(P<0.001),and the differences were statistically significant.2.FINS,HOMA-IR,C-peptide,ALT,γ-GGT,and SUA in the MASH group,MAFL group,and simple obesity group were significantly higher than those in the healthy control group(P<0.001),and AST/ALT was significantly smaller than that in the healthy control group(P<0.001),and the differences were statistically significant.There was no statistically significant difference between the simple obesity group and the MAFL group in the two-by-two comparison of the above indexes(P>0.05).3.Serum LECT2 level in healthy control group was significantly different from that in MASH group(P<0.0001),and significantly different from that in simple obesity group and MAFL group(P<0.005).There was a significant difference between simple obesity group and MASH group,which was statistically significant(P<0.0001).There was statistical difference between the MAFL group and MASH group(P<0.001).There was no statistical difference between the simple obesity group and the MAFL group(P>0.05).Serum PEDF level in healthy control group was significantly different from that in simple obesity group and MAFL group(P<0.005),and significantly different from that in MASH group(P<0.0001).There was significant difference between simple obesity group and MASH group,with statistical significance(P<0.001).There was statistical difference between MAFL group and MASH group(P<0.05).There was no statistical difference between simple obesity group and MAFL group(P>0.05).4.Serum LECT2 level was positively correlated with BMI,FINS,HOMA-IR,C-peptide,TG,ALT,AST,γ-GGT and SUA,and negatively correlated with AST/ALT.Serum PEDF level was positively correlated with BMI,FINS,HOMA-IR,C-peptide,ALT,AST and γ-GGT.It is negatively correlated with AST/ALT.5.According to the ROC curve and related indicators,it can be concluded that the combined use of LECT2 and NAFLD liver fat score to evaluate children’s MAFLD and MASH has significantly higher diagnostic and evaluation value than the combined use of a single indicator and other indicators.Conclusion1.LECT2 and PEDF can be used as serum biological indicators for the diagnosis of MAFLD in obese children,providing new biological evidence for the classification of MAFLD.2.The combination of serum LECT2 level and NAFLD liver fat score has high clinical diagnosis and evaluation value in MAFLD and MASH of obese children.3.This study provides a new technique for clinical diagnosis for MAFLD in children.