Serum proinflammatory cytokines and nutritional status in pediatric chronic liver disease

Table 1 Demographic and clinical data of the study population n (%)

Variables	Patients (n = 43)
Age (yr)
< 2	13 (30.2)
2-5	9 (20.9)
5-10	11 (25.6)
> 10	10 (23.3)
Female	23 (53.5)
Nutritional status1
Well-nourished	28 (65.1)
Risk of malnutrition	10 (23.3)
Malnutrition	5 (11.6)
Causes of chronic liver disease
Biliary atresia	31 (72)
Alpha-1 antitrypsin deficiency	6 (14)
Sinusoidal obstruction syndrome	1 (2.3)
Idiopathic chronic liver disease	1 (2.3)
Cirrhosis by cytomegalovirus	1 (2.3)
Cryptogenic cirrhosis	3 (7)
Cholestasis (CB ≥ 2.0 mg/dL)	12 (27.9)
Albumin (< 3.5 g/L)	12 (27.9)
Portal hypertension	24 (55.8)
Ascites	3 (7)
Hepatomegaly	25 (58.1)
Splenomegaly	32 (74.4)
Cirrhosis	35 (81.4)
Child-Pugh score
A	20/35 (57.1)
B	12/35 (34.3)
C	3/35 (8.6)
PELD score (> 15)	4/27 (14.8)
MELD score (> 15)	1/8 (12.5)

¹Parameters for nutritional assessment: triceps skinfold-for-age and body mass index-for-age. CB: Conjugated bilirubin; PELD: Pediatric end stage liver disease; MELD: Model for end stage liver disease.

Table 2 Cytokine levels in children with chronic liver disease at nutritional risk vs well-nourished

Cytokine	Nutritional risk	Well-nourished	P value1
Interleukin-1β (pg/mL)	0.10 (0-0.66)	0.05 (0-0.28)	0.144
Interleukin-6 (pg/mL)	7.12 (0.58-34.23)	1.63 (0.53-3.43)	0.020
TNF-α (pg/mL)	10.74 (8.17-12.35)	6.66 (4.28-11.26)	0.880

¹Mann-Whitney U test. Data are expressed as median (25^th-75^th centile). TNF-α: Tumor necrosis factor-α.

Table 3 Correlations between the interleukin-6 levels and routine liver function tests

Liver function tests	Median (25th-75th)	rs	P value
Aspartate aminotransferase (U/L)	73.50 (49.25-177.00)	0.70	< 0.001
Alanine aminotransferase (U/L)	60.00 (33.75-115.75)	0.49	0.001
Conjugated Bilirubin (mg/dL)	0.7 (0.2-2. 57)	0.72	< 0.001

r_s = Spearman correlation test.

Table 4 Multiple linear regression models for interleukin-6 levels adjusted for liver disease severity and nutritional status

Models1	β	P value
Child-Pugh score2	0.581	< 0.001
PELD/MELD score3	0.535	0.001

¹Logarithmic transformation was applied;

²Adjusted for nutritional status. R² = 37.8%;

³Adjusted for nutritional status. R² = 30.6%. PELD: Pediatric end stage liver disease; MELD: Model for end stage liver disease.