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Licensed Unlicensed Requires Authentication Published by De Gruyter November 2, 2021

Increased hepcidin levels and non-alcoholic fatty liver disease in obese prepubertal children: a further piece to the complex puzzle of metabolic derangements

  • Cosimo Giannini , Nella Polidori , Maria Alessandra Saltarelli , Francesco Chiarelli , Raffaella Basilico and Angelika Mohn EMAIL logo



Several studies on obese youths and adults have reported increased hepcidin levels, which seems to be related to metabolic and iron metabolism alterations. The complete mechanisms involved in hepcidin increase remain to be elucidated, and particularly its role in the development of other known complications such as Nonalcoholic Fatty Liver Disease (NAFLD). NAFLD in prepubertal children might be of special interest in understanding the underlying mechanisms.


Anthropometric measurements, liver ultrasonography, lipid profile, liver function, oxidative stress, inflammatory state, and iron metabolism were studied in 42 obese prepubertal children and 33 healthy controls. We, therefore, evaluated the presence of possible correlations between Hepcidin and the other metabolic variables, and the possible association between NAFLD and iron metabolism.


Hepcidin levels were significantly increased in the obese prepubertal children (p=0.001) with significant differences between obese children with and without NAFLD (p=0.01). Blood iron was lower in obese children (p=0.009). In the obese group, a negative correlation between hepcidin and both blood iron levels (p=0.01) and LagPHASE (p=0.02) was found. In addition, a positive association between hepcidin and NAFLD (p=0.03) was detected.


We suggest that an increase in hepcidin levels may represent an early step in iron metabolism derangements and metabolic alterations, including NAFLD, in prepubertal obese children.

Corresponding author: Angelika Mohn, Department of Pediatrics, University of Chieti, Chieti,Italy; and Clinical Research Center, “G. d’Annunzio” Foundation, University of Chieti, Via dei Vestini 5, Chieti I-66100, Italy, Phone: +39 0871358827, E-mail:
Cosimo Giannini and Nella Polidori contributed equally to this work.


(If applicable).

  1. Research funding: None declared.

  2. Author contribution: Each author has made substantial contributions to the conception or design of the study, participated in drafting the study or revising it critically for important intellectual content, approved the final version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The local Institutional Review Board deemed the study exempt from review.


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Received: 2021-02-01
Revised: 2021-09-25
Accepted: 2021-10-11
Published Online: 2021-11-02
Published in Print: 2022-01-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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