Öz

Objective: Childhood obesity is a growing global health problem linked to chronic inflammation and metabolic complications, including dyslipidemia, insulin resistance, type 2 diabetes mellitus, nonalcoholic fatty liver disease, and hypertension. Fetuin-A, a hepatokine involved in insulin signaling and inflammation, has been studied in adults, but its role in pediatric obesity is unclear. This study evaluated fetuin-A levels in obese adolescents and their association with anthropometric and metabolic parameters.

Materials and Methods: This cross-sectional study included 40 obese adolescents (BMI > 95th percentile) and 30 healthy controls (BMI between the 15th and 85th percentiles) who had no additional systemic diseases and were not receiving any medication. Anthropometric measurements and fasting glucose, insulin, high-sensitivity C-reactive protein, and fetuin-A were assessed. The presence of dyslipidemia, hepatic steatosis, and hypertension was evaluated.

Results: Hs-CRP levels were significantly higher in obese patients than in controls (p=0.015) However, fetuin-A levels did not differ significantly between the groups. Fetuin-A showed no correlation with insulin resistance, lipid parameters, hepatic steatosis, or hypertension.

Conclusion: Obesity-related complications (insulin resistance, dyslipidemia, fatty liver, and hypertension) were observed in more than half of our group. Although hs-CRP levels of obese cases were high, fetuin-A concentrations were observed to be similar in all cases and in subgroup analyzes. It may be due to factors affecting fetuin-A levels or its posttranslational modification. Further large-scale longitudinal studies are required to elucidate its contribution to metabolic inflammation in children.

Kaynakça

  1. Leung AKC, Wong AHC, Hon KL. Childhood Obesity: An Updated Review. Curr Pediatr Rev. 2024;20(1):2-26. https://doi.org/10.2174/1573396318666220801093225
  2. Podeanu MA, Ionele CM, Sandu RE, Rogoveanu I, Stepan MD, Niculescu CE, Cazacu SM, Vintilescu ȘB. Obesity, Metabolic Syndrome and MASLD in Children: Inflammation as the Missing Link-A Short Narrative Review. Life (Basel). 2026;16(2):310. https://doi.org/10.3390/life16020310
  3. Zhou ZW, Ju HX, Sun MZ, Chen HM, Fu QP, Jiang DM. Serum fetuin-A levels in obese and non-obese subjects with and without type 2 diabetes mellitus. Clin Chim Acta. 2018;476:98-102. https://doi.org/10.1016/j.cca.2017.11.023
  4. Trepanowski JF, Mey J, Varady KA. Fetuin-A: a novel link between obesity and related complications. Int J Obes (Lond). 2015;39:734-41. https://doi.org/10.1038/ijo.2014.203
  5. Reinauer C, Reinehr T, Baechle C, et al. Relationship of serum Fetuin A with metabolic and clinical parameters in German children and adolescents with type 1 diabetes. Horm Res Paediatr. 2018;89:73-81. https://doi.org/10.1159/000484896
  6. Ahn MB, Kim SK, Kim SH, et al. Clinical Significance of the Fetuin-A-to-Adiponectin Ratio in Obese Children and Adolescents with Diabetes Mellitus. Children (Basel). 2021;8(12):1155. https://doi.org/10.3390/children8121155
  7. Jirak P, Stechemesser L, Moré E, et al. Clinical implications of fetuin-A. Adv Clin Chem. 2019;89:79-130. https://doi.org/10.1016/bs.acc.2018.12.003
  8. Elhoseeny MM, Abdulaziz BA, Mohamed MA, Elsharaby RM, Rashad GM, Othman AAA. Fetuin-A: a relevant novel serum biomarker for non-invasive diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD): a retrospective case-control study. BMC Gastroenterol. 2024;24(1):226. https://doi.org/10.1186/s12876-024-03310-y
  9. Gavril OI, Adam CA, Stamate TC, et al. Fetuin-A as a Link Between Dyslipidemia and Cardiovascular Risk in Type 2 Diabetes: A Metabolic Insight for Clinical Practice. Biomedicines. 2025;13(9):2098. https://doi.org/10.3390/biomedicines13092098
  10. Pampanini V, Inzaghi E, Germani D, et al. Serum Fetuin-A levels in obese children with biopsy proven nonalcoholic fatty liver disease. Nutr Metab Cardiovasc Dis. 2018;281:71-6. https://doi.org/10.1016/j.numecd.2017.09.008
  11. Lebensztejn DM, Białokoz-Kalinowska I, Kłusek-Oksiuta M, Tarasów E, Wojtkowska M, Kaczmarski M. Serum fetuin A concentration is elevated in children with non-alcoholic fatty liver disease. Adv Med Sci. 2014;59:81-4. https://doi.org/10.1016/j.advms.2013.08.003
  12. Hızlı Ş, Abacı A, Özdemir O, Akelma Z, Akın O. Relation of fetuin A levels with cardiac, subcutaneous lipid accumulation and insulin resistance parameters in Turkish obese children. J Pediatr Endocrinol Metab. 2016;29:669-73. https://doi.org/10.1515/jpem-2015-0430
  13. Manco M, Nobili V, Alisi A, Panera N, Handberg A. Arterial stiffness, thickness and association to suitable novel markers of risk at the origin of cardiovascular disease in obese children. Int J Med Sci. 2017;14:711-20. https://doi.org/10.7150/ijms.20126
  14. Selvaraju V, Babu JR, Geetha T. Multiplexed measurements of salivary fetuin-A, insulin, and adiponectin as potential non-invasive biomarkers in childhood obesity. Cytokine. 2022;153:155843. https://doi.org/10.1016/j.cyto.2022.155843
  15. Kącka A, Charemska A, Jarocka-Cyrta E, Głowińska-Olszewska B. Comparison of novel markers of metabolic complications and cardiovascular risk factors between obese non-diabetic and obese type 1 diabetic children and young adults. Front Endocrinol (Lausanne). 2022;13:1036109. https://doi.org/10.3389/fendo.2022.1036109
  16. Demir K, Konakçı E, Özkaya G, et al. New features for child metrics: Further growth references and blood pressure calculations. J Clin Res Pediatr Endocrinol. 2020;12:125-9. https://doi.org/10.4274/jcrpe.galenos.2019.2019.0127
  17. Kurtoğlu S, Hatipoğlu N, Mazıcıoğlu M, Kendirici M, Keskin M, Kondolot M. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods. J Clin Res Pediatr Endocrinol. 2010; 2:100-6. https://doi.org/10.4274/jcrpe.v2i3.100
  18. Hampl SE, Hassink SG, Skinner AC, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics. 2023;151(2):e2022060640. https://doi.org/10.1542/peds.2022-060640
  19. Flynn JT, Daniels SR, Hayman LL, et al. American Heart Association Atherosclerosis, Hypertension and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young. Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association. Hypertension. 2014;63(5):1116-35. https://doi.org/10.1161/HYP.0000000000000007
  20. Robinson KN, Teran-Garcia M. From infancy to aging: Biological and behavioral modifiers of Fetuin-A. Biochimie. 2016;124:141-9. https://doi.org/10.1016/j.biochi.2015.12.016
  21. Ren Y, Zhao H, Yin C, Lan X, Wu L, Du X, Griffiths HR, Gao D. Adipokines, Hepatokines and Myokines: Focus on Their Role and Molecular Mechanisms in Adipose Tissue Inflammation. Front Endocrinol (Lausanne). 2022;13:873699. https://doi.org/10.3389/fendo.2022.873699
  22. Kim JE, Kim JS, Jo MJ, Cho E, Ahn SY, Kwon YJ, Ko GJ. The Roles and Associated Mechanisms of Adipokines in Development of Metabolic Syndrome. Molecules. 2022;27(2):334. https://doi.org/10.3390/molecules27020334
  23. Iglesias P. The endocrine role of hepatokines: implications for human health and disease. Front Endocrinol (Lausanne). 2025;16:1663353. https://doi.org/10.3389/fendo.2025.1663353
  24. Ataeinosrat A, Abednatanzi H, Hajesfandiari S, Al Nasser MN, Dara MM, Farzanegi P, Nahand MS, Almaqhawi A, Karimi N, Bagherzadeh-Rahmani B, Saeidi A, Laher I, Zouhal H. Hepatokines modulation in obesity: which exercise training model is better in men with obesity? Front Endocrinol (Lausanne). 2025;16:1560453. https://doi.org/10.3389/fendo.2025.1560453

Nasıl atıf yapılır

1.
Karacan Küçükali G, Çetinkaya S, Kurnaz E, Bayramoğlu E, Özalkak Ş, Demirci G, et al. The role of fetuin-A in adolescent obesity: Association with anthropometric and metabolic parameters. Turk J Pediatr Dis. 2026;20(4):290-294. https://doi.org/10.12956/TJPD.2026.1322