Di Sessa A, Umano GR, Cirillo G, Passaro AP, Verde V, Cozzolino D, Guarino S, Marzuillo P, Miraglia del Giudice E. Pediatric non-alcoholic fatty liver disease and kidney function: Effect of HSD17B13 variant. World J Gastroenterol 2020; 26(36): 5474-5483 [PMID: 33024398 DOI: 10.3748/wjg.v26.i36.5474]
Corresponding Author of This Article
Pierluigi Marzuillo, MD, PhD, Doctor, Postdoc, Postdoctoral Fellow, Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania Luigi Vanvitelli, Via Luigi De Crecchio 2, Napoli 80138, Italy. pierluigi.marzuillo@gmail.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Sep 28, 2020; 26(36): 5474-5483 Published online Sep 28, 2020. doi: 10.3748/wjg.v26.i36.5474
Pediatric non-alcoholic fatty liver disease and kidney function: Effect of HSD17B13 variant
Anna Di Sessa, Giuseppina Rosaria Umano, Grazia Cirillo, Antonio Paride Passaro, Valentina Verde, Domenico Cozzolino, Stefano Guarino, Pierluigi Marzuillo, Emanuele Miraglia del Giudice
Anna Di Sessa, Giuseppina Rosaria Umano, Grazia Cirillo, Antonio Paride Passaro, Valentina Verde, Stefano Guarino, Pierluigi Marzuillo, Emanuele Miraglia del Giudice, Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania Luigi Vanvitelli, Napoli 80138, Italy
Domenico Cozzolino, Department of Internal Medicine, Università degli Studi della Campania Luigi Vanvitelli, Napoli 80138, Italy
Author contributions: Di Sessa A and Miraglia del Giudice E contributed to the research idea and study design; Guarino S, Umano GR, Passaro AP, and Verde V contributed to data acquisition; Cirillo G and Umano GR contributed to the molecular analysis; Marzuillo P, Miraglia del Giudice E and Cozzolino D contributed to the data analysis/interpretation; Di Sessa A and Marzuillo P contributed to statistical analysis; Miraglia del Giudice E and Marzuillo P contributed to supervision or mentorship. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.
Institutional review board statement: The study was approved by the Institutional Review Board of Università degli Studi della Campania Luigi Vanvitelli.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Nothing to declare.
Data sharing statement: Datasets generated during analyses are available on request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Pierluigi Marzuillo, MD, PhD, Doctor, Postdoc, Postdoctoral Fellow, Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania Luigi Vanvitelli, Via Luigi De Crecchio 2, Napoli 80138, Italy. pierluigi.marzuillo@gmail.com
Received: April 1, 2020 Peer-review started: April 1, 2020 First decision: May 29, 2020 Revised: June 2, 2020 Accepted: September 4, 2020 Article in press: September 4, 2020 Published online: September 28, 2020 Processing time: 175 Days and 7.5 Hours
ARTICLE HIGHLIGHTS
Research background
Accumulating data supports a genetic link between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD), mostly sustained by both the major NAFLD risk polymorphisms such as the I148M polymorphism in the patatin like phospholipase containing domain 3 (PNPLA3) and the E167K allele in the transmembrane 6 superfamily member 2 gene (TM6SF2). Recently the hydroxysteroid 17-beta dehydrogenase 13 (HSD17B13) gene has been recognized as a novel genetic variant involved in NAFLD pathophysiology with a protective role against liver damage both in adults and children.
Research motivation
Despite a growing interest regarding the potential genetic link between NAFLD and CKD, available literature data showed no studies investigating the effect of the rs72613567:TA variant of the HSD17B13 gene on estimated glomerular filtration rate (eGFR) in obese children.
Research objectives
In this study we aimed to evaluate the impact of the rs72613567:TA variant of the HSD17B13 gene on estimated glomerular filtration rate (eGFR) in obese children.
Research methods
Anthropometric, laboratory, and instrumental evaluations were conducted in all the enrolled 684 obese children. NAFLD was defined by ultrasound detected liver steatosis and/or alanine aminotransferase (ALT) levels > 40 IU/L. Genotyping for the rs72613567:TA variant of the HSD17B13 gene in all the enrolled subjects was also performed.
Research results
Patients carrying the HSD17B13 rare A allele had higher eGFR levels than homozygous patients both among subjects with and without NAFLD. This association was independent of PNPLA3 and TM6SF2 polymorphisms both in patients with and without NAFLD. The eGFR decline in homozygous subjects for HSD17B13 genotype with and without NAFLD was more markedly with the increase of the age than in carriers the HSD17B13 rare A allele.
Research conclusions
In line with the beneficial effect against NAFLD risk, the rs72613567:TA variant of the HSD17B13 gene exerts a protective role also on renal function in obese children with and without NAFLD and independently of PNPLA3 I148M and TM6SF6 E167K polymorphisms.
Research perspectives
Findings from this study highlight the importance of a better NAFLD genetic assessment as possible clinical tool for improved strategies to identify patients at higher cardiometabolic risk already in childhood.
