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Low Hepatic Tissue Copper in Pediatric Nonalcoholic Fatty Liver Disease

Michael Mendoza1, Shelley Caltharp, Ming Song

  • 1*Department Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition †Department of Pediatrics, Division of Pediatric Pathology, Emory University ‡Children's Healthcare of Atlanta at Egleston, Atlanta, GA §Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Louisville School of Medicine, Louisville, KY.

Journal of Pediatric Gastroenterology and Nutrition
|June 24, 2017
PubMed

Insights

In pediatric nonalcoholic fatty liver disease (NAFLD), lower copper levels are linked to increased disease severity. This finding suggests copper may play a role in NAFLD progression in children.

Area of Science:

  • Hepatology
  • Pediatric Gastroenterology
  • Nutritional Biochemistry

Background:

  • Animal models and adult studies indicate copper restriction exacerbates nonalcoholic fatty liver disease (NAFLD) liver injury.
  • The relationship between copper levels and NAFLD severity in pediatric populations remains understudied.

Purpose of the Study:

  • To investigate the association between tissue copper levels and the severity of NAFLD in children.
  • To determine if lower hepatic copper concentrations correlate with increased NAFLD indicators in pediatric patients.

Main Methods:

  • Retrospective analysis of pediatric liver biopsy data, including hepatic copper quantitation.
  • Comparison of hepatic copper concentrations between NAFLD and non-NAFLD pediatric groups.
  • Correlation analysis of tissue copper levels with steatosis, fibrosis, lobular inflammation, balloon degeneration, and NAFLD activity score (NAS).

Main Results:

  • Pediatric subjects with NAFLD exhibited significantly lower hepatic copper levels compared to non-NAFLD subjects, even after adjusting for confounding factors (P=0.005).
  • A significant inverse correlation was observed between tissue copper concentration and the severity of steatosis (P<0.001).
  • No significant association was found between copper levels and the degree of fibrosis, lobular inflammation, portal inflammation, or balloon degeneration.

Conclusions:

  • Decreased tissue copper levels are associated with NAFLD in pediatric patients.
  • Lower copper levels were observed in nonalcoholic steatohepatitis (a more severe form) compared to simple steatosis.
  • Further research is warranted to elucidate the role of copper in NAFLD pathogenesis and progression in children.
Abstract

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