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Background Although there are several studies on the prevalence of metabolic syndrome ( MetS) in childhood cancer survivors ( CCS), the association between MetS components and serum adipocytokine level has not been elucidated. Methods The charts of 49 patients (27 male, 22 female) who had attended the CCS clinic of the Department of Pediatrics, Kyoto University Hospital, between April 2009 and March 2010 were retrospectively reviewed. Median age was 10.7 years, and the median interval since the completion of chemotherapy was 5.1 years. The diagnosis of MetS was made based on the Japanese criteria for either children or adults. Results Three (6.1%) of 49 patients fulfilled the criteria for MetS, and 28 (57.1%) had at least one component of MetS. High leptin level was seen in 18 patients (36.7%), and low total adiponectin level was seen in 20 (40.8%). The number of patients with high leptin was correlated with body mass index z-score (>2.0), abdominal circumference/height (≥0.5), diastolic blood pressure and fasting blood sugar. The number of patients with low total adiponectin was correlated with systolic blood pressure and triglyceride. When the patients were divided into three groups based on the number of positive MetS components (0, 1 and 2-4), leptin and adiponectin tended to be higher and lower in the third group, respectively. Conclusions Adipocytokines may play a role in the pathogenesis of MetS occurring in CCS. It is recommended that adipocytokines be evaluated together with MetS components at the CCS follow-up clinics. [ABSTRACT FROM AUTHOR]

Summary: Background: NASH is expected to be a major target disease in near future, although we are too short in information to realize NASH. In this study, we revealed the prevalence of fatty liver, which is a background disease of NASH, in Kyoto. Then we made histological diagnosis of NASH from chronic liver disorder with fatty liver. Materials and methods: By using the data obtained from medical check-up with more than 1000 subjects per year in Kyoto, the prevalence of fatty liver on ultrasound, serum ALT, body mass index (BMI) were compared between 1994 and 2004. Next 32 patients with elevated ALT and bright liver on ultrasound were biopsied in order to diagnose them as NASH or not. Biochemical, serological and hormonal parameters as well as adipocytokine profiles were also studied. Lastly, liver tissues from those patients were examined to compare the expression of peroxisome proliferator activator receptor (PPAR) alpha and gamma. Results: It was revealed that the prevalence of fatty liver increased from 12.9 to 34.7% over 10 years. The mean ALT and BMI also increased in this period. From 32 patients, 6 cases were excluded for alcohol, autoimmune hepatitis, and drug-induced liver injury, leaving 26 cases to enter the study. Among them, 12 and 8 patients showed grade 1 and grade 2 steatohepatitis, which were consistant with NASH. Various data were compared among simple steatosis, grade 1 steatohepatitis, and grade 2 steatohepatitis, but highly sensitive CRP was the sole parameter with statistical significance. PPAR alpha seems to be expressed higher in patients with steatohepatitis, although PPAR alpha did not show any significance. Conclusion: We found the prevalence of fatty liver was increasing over 10 years. The histological examination showed more patients with grade 1 or grade 2 steatohepatitis than expected, which means we might have much more NASH cases undiagnosed. We were unable to propose reliable diagnostic markers to diagnose NASH from this study. [Copyright &y& Elsevier]