Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

IMPACT FACTOR 2017: 1.086

CiteScore 2017: 1.07

SCImago Journal Rank (SJR) 2017: 0.465
Source Normalized Impact per Paper (SNIP) 2017: 0.580

See all formats and pricing
More options …
Volume 27, Issue 5-6


Investigation of adropin and leptin levels in pediatric obesity-related nonalcoholic fatty liver disease

Oya Sayın / Yavuz Tokgöz
  • Diyarbakir Children Hospital, Department of Pediatric Gastroenterology, Hepatology, Diyarbakir, Turkey
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nur Arslan
  • Corresponding author
  • Division of Pediatric Gastroenterology, Hepatology and Nutrition, Dokuz Eylul University Faculty of Medicine, Department of Pediatrics, Izmir, Turkey
  • Dokuz Eylul University Health Science Institute, Department of Molecular Medicine, Izmir, Turkey
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2014-01-27 | DOI: https://doi.org/10.1515/jpem-2013-0296


Aim: Nonalcoholic fatty liver disease (NAFLD) is the accumulation of excess fat in the liver in the absence of alcohol consumption, which is commonly associated with obesity and increased risk of atherosclerosis as well as insulin resistance. Adropin is a recently identified protein encoded by the gene related with energy homeostasis, which is expressed in the liver and the brain and has a role in preventing insulin resistance and obesity. The aim of this study was to investigate the serum adropin and leptin levels in obese adolescents and compare the patients with, and without, NAFLD and with healthy controls.

Methods: Sixty-four obese adolescents (30 with NAFLD, 34 without NAFLD) and 36 healthy controls were enrolled in the study. Serum adropin and leptin levels were evaluated by sandwich enzyme-linked immunosorbent assay.

Results: Serum adropin levels were significantly lower in obese children than healthy controls (3.2±1.0 and 9.2±1.2 ng/mL, respectively, p=0.001). Serum leptin levels were significantly higher in patients than in controls (12.4±1.1 and 4.1±3.1 pg/mL, respectively; p=0.000). Serum adropin levels of patients with NAFLD were significantly lower than in patients without NAFLD (2.9±0.5 and 3.5±1.2 ng/mL, respectively; p=0.023) and healthy controls (p=0.000). Logistic regression analysis showed that a decrease in adropin levels was the only independent factor for fatty liver disease in obese adolescents (odds ratio: 3.07, 95% confidence interval 1.14–8.2, p=0.026). Leptin, relative weight and HOMA-IR of the patients were not independent risk factors for NAFLD.

Conclusions: In this study, serum adropin levels were significantly lower in obese adolescents with fatty liver disease compared to patients without fatty liver disease and healthy controls. Lower adropin level was an independent risk factor for NAFLD in obese adolescents in logistic regression analysis. Assessment of serum adropin concentrations may provide a reliable indicator of fatty liver disease in obese adolescents.

Keywords: adolescent; adropin; fatty liver disease; leptin; obesity


  • 1.

    Arslan N, Tokgoz Y, Kume T, Bulbul M, Sayın O, et al. Evaluation of serum neopterin levels and its relationship with adipokines in pediatric obesity-related nonalcoholic fatty liver disease and healthy adolescents. J Pediatr Endocrinol Metab 2013;26:1141–7.Web of ScienceGoogle Scholar

  • 2.

    Arslan N, Makay B. Mean platelet volume in obese adolescents with nonalcoholic fatty liver disease. J Pediatr Endocrinol Metab 2010;23:807–13.Web of SciencePubMedGoogle Scholar

  • 3.

    Mencin AA, Lavine JE. Nonalcoholic fatty liver disease in children. Curr Opin Clin Nutr Metab Care 2011;14:151–7.PubMedGoogle Scholar

  • 4.

    Aly FZ, Kleiner DE. Update on fatty liver disease and steatohepatitis. Adv Anat Pathol 2011;18:294–300.CrossrefWeb of SciencePubMedGoogle Scholar

  • 5.

    Arslan N, Erdur B, Aydın A. Hormones and cytokines in childhood obesity. Indian Pediatr 2010;47:829–39.Web of ScienceCrossrefPubMedGoogle Scholar

  • 6.

    Siegrist M, Rank M, Wolfarth B, Langhof H, Haller B, et al. Leptin, adiponectin, and short-term and long-term weight loss after a lifestyle intervention in obese children. Nutrition 2013;29:851–7.CrossrefPubMedGoogle Scholar

  • 7.

    Wang Q, Yin J, Xu L, Cheng H, Zhao X, et al. Prevalence of metabolic syndrome in a cohort of Chinese schoolchildren: comparison of two definitions and assessment of adipokines as components by factor analysis. BMC Public Health 2013;13:249.CrossrefWeb of ScienceGoogle Scholar

  • 8.

    Kumar KG, Trevaskis JL, Lam DD, Sutton GM, Koza RA, et al. Identification of adropin as a secreted factor linking dietary macronutrient intake with energy homeostasis and lipid metabolism. Cell Metab 2008;8:468–81.CrossrefWeb of SciencePubMedGoogle Scholar

  • 9.

    Lian W, Gu X, Qin Y, Zheng X. Elevated plasma levels of adropin in heart failure patients. Intern Med 2011;50:1523–7.CrossrefWeb of SciencePubMedGoogle Scholar

  • 10.

    Aydin S, Kuloglu T, Aydin S, Eren MN, Yilmaz M, et al. Expression of adropin in rat brain, cerebellum, kidneys, heart, liver, and pancreas in streptozotocin-induced diabetes. Mol Cell Biochem 2013;380:73–81.CrossrefWeb of ScienceGoogle Scholar

  • 11.

    Aydin S. Presence of adropin, nesfatin-1, apelin-12, ghrelins and salusins peptides in the milk, cheese whey and plasma of dairy cows. Peptides 2013;43:83–7.Web of ScienceGoogle Scholar

  • 12.

    Gozal D, Kheirandish-Gozal L, Bhattacharjee R, Molero-Ramirez H, Tan HL, et al. Circulating adropin concentrations in pediatric obstructive sleep apnea: potential relevance to endothelial function. J Pediatr 2013;163:1122–6.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 13.

    Celik A, Balin M, Kobat MA, Erdem K, Baydas A, et al. Deficiency of a new protein associated with cardiac syndrome X; called adropin. Cardiovasc Ther 2013;31:174–8.CrossrefPubMedWeb of ScienceGoogle Scholar

  • 14.

    Celik E, Yilmaz E, Celik O, Ulas M, Turkcuoglu I, et al. Maternal and fetal adropin levels in gestational diabetes mellitus. J Perinat Med 2013;41:375–80.Web of ScienceGoogle Scholar

  • 15.

    Butler AA, Tam CS, Stanhope KL, Wolfe BM, Ali MR, et al. Low circulating adropin concentrations with obesity and aging correlate with risk factors for metabolic disease and increase after gastric bypass surgery in humans. J Clin Endocrinol Metab 2012;97:3783–91.CrossrefGoogle Scholar

  • 16.

    Strauss RS. Childhood obesity. Pediatr Clin North Am 2002;49:175–201.CrossrefPubMedGoogle Scholar

  • 17.

    Shannon A, Alkhouri N, Carter-Kent C, Monti L, Devito R, et al. Ultrasonographic quantitative estimation of hepatic steatosis in children with NAFLD. J Pediatr Gastroenterol Nutr 2011;53:190–5.Web of ScienceCrossrefGoogle Scholar

  • 18.

    Quinn SF, Gosink BB. Characteristic sonographic signs of hepatic fatty infiltration. AJR Am J Roentgenol 1985;145:753–5.PubMedCrossrefGoogle Scholar

  • 19.

    Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.CrossrefGoogle Scholar

  • 20.

    Kumar KG, Zhang J, Gao S, Rossi J, McGuinness OP, et al. Adropin deficiency is associated with increased adiposity and insulin resistance. Obesity (Silver Spring) 2012;20:1394–402.CrossrefGoogle Scholar

  • 21.

    Ruiz-Extremera Á, Carazo Á, Salmerón Á, León J, Casado J, et al. Factors associated with hepatic steatosis in obese children and adolescents. J Pediatr Gastroenterol Nutr 2011;53:196–201.CrossrefWeb of ScienceGoogle Scholar

  • 22.

    Kim IK, Kim J, Kang JH, Song J. Serum leptin as a predictor of fatty liver in 7-year-old Korean children. Ann Nutr Metab 2008;53:109–16.Web of ScienceGoogle Scholar

  • 23.

    Canas JA, Damaso L, Altomare A, Killen K, Hossain J, et al. Insulin resistance and adiposity in relation to serum β-carotene levels. J Pediatr 2012;161:58–64.CrossrefWeb of ScienceGoogle Scholar

  • 24.

    Gherlan I, Vladoiu S, Alexiu F, Giurcaneanu M, Oros S, et al. Adipocytokine profile and insulin resistance in childhood obesity. Maedica (Buchar) 2012;7:205–13.Google Scholar

  • 25.

    Pacifico L, Bezzi M, Lombardo CV, Romaggioli S, Ferraro F, et al. Adipokines and C-reactive protein in relation to bone mineralization in pediatric nonalcoholic fatty liver disease. World J Gastroenterol 2013;19:4007–14.Web of ScienceCrossrefGoogle Scholar

  • 26.

    Fitzpatrick E, Dew TK, Quaglia A, Sherwood RA, Mitry RR, et al. Analysis of adipokine concentrations in paediatric non-alcoholic fatty liver disease. Pediatr Obes 2012;7:471–9.CrossrefWeb of ScienceGoogle Scholar

  • 27.

    Lebensztejn DM, Wojtkowska M, Skiba E, Werpachowska I, Tobolczyk J, et al. Serum concentration of adiponectin, leptin and resistin in obese children with non-alcoholic fatty liver disease. Adv Med Sci 2009;54:177–82.Web of ScienceGoogle Scholar

  • 28.

    Machado MV, Coutinho J, Carepa F, Costa A, Proença H, et al. How adiponectin, leptin, and ghrelin orchestrate together and correlate with the severity of nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol 2012;24:1166–72.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 29.

    Mager DR, Yap J, Rodriguez-Dimitrescu C, Mazurak V, Ball G, et al. Anthropometric measures of visceral and subcutaneous fat are important in the determination of metabolic dysregulation in boys and girls at risk for nonalcoholic fatty liver disease. Nutr Clin Pract 2013;28:101–11.CrossrefWeb of ScienceGoogle Scholar

  • 30.

    Fitzpatrick E, Mitry RR, Quaglia A, Hussain MJ, DeBruyne R, et al. Serum levels of CK18 M30 and leptin are useful predictors of steatohepatitis and fibrosis in paediatric NAFLD. J Pediatr Gastroenterol Nutr 2010;51:500–6.CrossrefWeb of ScienceGoogle Scholar

  • 31.

    Arslan N, Büyükgebiz B, Oztürk Y, Cakmakçi H. Fatty liver in obese children: prevalence and correlation with anthropometric measurements and hyperlipidemia. Turk J Pediatr 2005;47:23–7.PubMedGoogle Scholar

About the article

Corresponding author: Nur Arslan, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Dokuz Eylul University Faculty of Medicine, Department of Pediatrics, Izmir, Turkey, Phone: +90 2324126107, Fax: +90 2324126005, E-mail: ; and Dokuz Eylul University Health Science Institute, Department of Molecular Medicine, Izmir, Turkey

Received: 2013-07-15

Accepted: 2013-12-16

Published Online: 2014-01-27

Published in Print: 2014-05-01

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 27, Issue 5-6, Pages 479–484, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2013-0296.

Export Citation

©2014 by Walter de Gruyter Berlin/Boston.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Spencer P. Loewen and Alastair V. Ferguson
American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2017, Volume 312, Number 4, Page R511
Artemis Bousmpoula, Evangelia Kouskouni, Evangelos Benidis, Styliani Demeridou, Rachil Kapeta-Kourkouli, Anthia Chasiakou, and Stavroula Baka
Gynecological Endocrinology, 2017, Page 1
Bilge G. Tuna, Pinar B. Atalay, Mine Altunbek, Batuhan M. Kalkan, and Soner Dogan
Nutrition and Cancer, 2017, Page 1
Chi-Ming Wong, Yudong Wang, Jimmy Tsz Hang Lee, Zhe Huang, Donghai Wu, Aimin Xu, and Karen Siu Ling Lam
Journal of Biological Chemistry, 2014, Volume 289, Number 37, Page 25976
Ruth C. R. Meex and Matthew J. Watt
Nature Reviews Endocrinology, 2017, Volume 13, Number 9, Page 509
Lorena del Rocío Ibarra-Reynoso, Liudmila Pisarchyk, Elva Leticia Pérez-Luque, Ma. Eugenia Garay-Sevilla, Juan Manuel Malacara, and Rasheed Ahmad
PLoS ONE, 2014, Volume 9, Number 11, Page e113576
Joseph R. Stevens, Monica L. Kearney, Marie-Pierre St-Onge, Kimber L. Stanhope, Peter J. Havel, Jill A. Kanaley, John P. Thyfault, Edward P. Weiss, and Andrew A. Butler
Obesity, 2016, Volume 24, Number 8, Page 1731
Jonathan Temple, Paul Cordero, Jiawei Li, Vi Nguyen, and Jude Oben
International Journal of Molecular Sciences, 2016, Volume 17, Number 6, Page 947
T. Kume, M. Calan, O. Yilmaz, G. U. Kocabas, P. Yesil, M. Temur, M. Bicer, and O. G. Calan
Journal of Endocrinological Investigation, 2016, Volume 39, Number 7, Page 747
Aboutaleb Beigi, Nooshin Shirzad, Fatemeh Nikpour, Ensieh Nasli Esfahani, Solaleh Emamgholipour, and Fatemeh Bandarian
Gynecological Endocrinology, 2015, Volume 31, Number 12, Page 939
Ayça Altincik and Oya Sayin
Journal of Pediatric Endocrinology and Metabolism, 2015, Volume 28, Number 9-10
Celebi Kocaoglu, Muammer Buyukinan, Said Sami Erdem, and Ahmet Ozel
Journal of Pediatric Endocrinology and Metabolism, 2015, Volume 28, Number 11-12
Liang-Ping Zhao, Wei-Ting Xu, Li Wang, Tao You, Siew-Pang Chan, Xin Zhao, and Xiang-Jun Yang
Heart, Lung and Circulation, 2015, Volume 24, Number 10, Page 975
Su Gao, Ryan P. McMillan, Qingzhang Zhu, Gary D. Lopaschuk, Matthew W. Hulver, and Andrew A. Butler
Molecular Metabolism, 2015, Volume 4, Number 4, Page 310
Zili Zhang, Feng Zhang, Yin Lu, and Shizhong Zheng
Hepatology Research, 2015, Volume 45, Number 2, Page 162

Comments (0)

Please log in or register to comment.
Log in