https://www.ncbi.nlm.nih.gov/pubmed/28319602

Mendoza M, Caltharp S, Song M, Collin L, Konomi JV, McClain CJ, Vos MB. J Pediatr Gastroenterol Nutr. 2017 Mar 17.

Abstract

OBJECTIVE:
Animal models and studies in adults have demonstrated that copper restriction increases severity of liver injury in non-alcoholic fatty liver disease (NAFLD). This has not been studied in children. We aimed to determine if lower tissue copper is associated with increased NAFLD severity in children.

METHODS:
This was a retrospective study of pediatric patients who had a liver biopsy including a hepatic copper quantitation. The primary outcome compared hepatic copper concentration in NAFLD versus non-NAFLD. Secondary outcomes compared hepatic copper levels against steatosis, fibrosis, lobular inflammation, balloon degeneration, and NAFLD activity score (NAS).

RESULTS:
The study analysis included 150 pediatric subjects (102 with NAFLD and 48 non-NAFLD). After adjusting for age, BMI z-score, GGT, ALT, and total bilirubin, NAFLD subjects had lower levels of hepatic copper than non-NAFLD (p = 0.005). Additionally, tissue copper concentration decreased as steatosis severity increased (p < 0.001). Copper levels were not associated with degree of fibrosis, lobular inflammation, portal inflammation, or balloon degeneration.

CONCLUSIONS:
In this cohort of pediatric subjects with NAFLD, we observed decreased tissue copper levels in subjects with NAFLD when compared to non-NAFLD subjects. Additionally, tissue copper levels were lower in subjects with non-alcoholic steatohepatitis, a more severe form of the disease, when compared to steatosis alone. Further studies are needed to explore the relationship between copper levels and NAFLD progression.