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Endotoxin Markers Are Elevated in Adolescents With Obesity With and Without Metabolic Dysfunction-Associated
Alison M Boone1, Alyssa M Bartlett1, Jordan A Bays1
1Department of Pediatrics, Section of Diabetes & Endocrinology, University of Oklahoma Health Campus, Oklahoma City, Oklahoma, USA.
Background:
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease in paediatric patients. Adult and murine studies have suggested a role for endotoxin from gram-negative bacteria in the development of MASLD, but there is incomplete and conflicting evidence for its role in adolescents.
Purpose:
To determine if adolescents with biopsy-proven MASLD have elevated endotoxin activity and whether endotoxin markers are associated with liver histological features.
Methods:
Serum endotoxin core antibodies (EndoCab IgG), lipopolysaccharide binding protein (LBP), soluble CD14 (sCD14) and C-reactive protein (CRP) were measured in adolescents with obesity and MASLD (n = 46), and control groups without MASLD with obesity (Ob, n = 28) or normal weight (NW, n = 34).
Results:
Compared to the NW group, both the MASLD and Ob groups had higher EndoCab IgG (56%), LBP (33%) and CRP (11-fold), while sCD14 did not differ. LBP and CRP were positively correlated to trunk and total body fat (r = 0.45 and 0.64, respectively), and to one another (r = 0.42), all p < 0.001. None of the endotoxin markers varied between boys and girls, or with liver steatosis grade or fibrosis stage within the MASLD group.
Conclusion:
Serum markers of endotoxin activity and inflammation are increased in adolescents with obesity but are not further increased in patients with mild to moderate MASLD.
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