The Role of Zonulin in the Development of Liver Fibrosis in Obese Adolescents

Abstract

The aim: To study the relationship between zonulin level and PNFI (pediatric non-alcoholic fatty liver disease fibrosis index) in obese adolescents. Material and methods: A total of fifty-nine obese subjects aged 12-17 years and thirteen healthy subjects were included in the study. Clinical, biochemical parameters, including serum zonulin, were examined and abdominal ultrasound examination was performed. For the assessment of liver fibrosis PNFI was calculated. Results: According to ultrasound examination 71,2% of obese adolescents had non-alcoholic fatty liver disease (NAFLD). Calculation of PNFI showed that 25,4% of obese subjects had fibrotic processes in the liver. Obese adolescents had significantly higher zonulin levels compared to normal weight peers – 91,8±3,1 vs 15,9±5,1 respectively (р<0,01). A significant positive correlation was established between zonulin levels and such parameters as body mass index, waist circumference / height ratio, triglycerides, very low-density lipoprotein cholesterol, insulin, homeostasis model assessment of insulin resistance, PNFI (p<0,05). Conclusions: The level of zonulin increases with an increase of the index for evaluating liver fibrosis (PNFI) in obese adolescents. This may indicate the effect of the state of the intestinal barrier on the development and progression of obesity-related liver pathology, namely NAFLD, in obese adolescents.

Value of zonulin as a diagnostic and prognostic marker in different degrees of nonalcoholic fatty liver disease

“…Our study is in agreement with the study of Parkhomenko et al which reported a higher serum zonulin levels in obese adolescents compared to healthy individuals. Using zonulin, it was shown that above 209.35 pc/ mL, it can discriminate between cases and control with AUC of 0.880, level of sensitivity 72.5%, specificity 100%, PPV 100%, NPV 64.5%, and accuracy 81.7% [28].…”