Background Obesity prevalence is increasing in children. It is associated with various comorbidities including nonalcoholic fatty liver disease (NAFLD). Hsp90 isoforms were identified in previous proteomic studies as potential biomarkers for NAFLD. The aim of the study was to analyze circulating levels of Hsp90α and Hsp90β in overweight and obese children. In addition, Hsp90α and Hsp90β were evaluated as biomarkers for NAFLD in overweight and obese children. Methods 68 overweight and obese children and ten age- and gender-matched controls were recruited. Hsp90α and Hsp90β levels were analyzed from serum in both controls and overweight and obese children by ELISA. Results Serum Hsp90β and total Hsp90 levels were statistically significantly higher in overweight and obese children compared to controls. On the contrary, there was no difference in Hsp90α levels between overweight and obese children and healthy controls. Hsp90 isoforms had different expression in NAFLD patients. Hsp90β levels were higher in overweight and obese NAFLD patients while Hsp90α levels were lower. Hsp90α to Hsp90β ratio had better accuracy for NAFLD diagnosis in obese and overweight patients compared to individual biomarkers. Conclusion Hsp90 isoforms were confirmed on an independent cohort as biomarkers for NAFLD in overweight and obese children. In these patients, it seems to be more useful to separately analyze Hsp90 isoforms rather than total Hsp90 as the isoforms have greater discriminative capacity.

NAFLD obese patients had higher prevalence of MetS, higher BMI and particular lipid profile pattern. Triglyceride levels independently associated with NAFLD after adjusting for age and MetS presence. According to our findings we suggest early triglyceride testing (even below the age of ten) in selected patients.

The aim of the study was to evaluate serum Endocan and Lumican levels as biomarkers for pediatric Nonalcoholic Fatty Liver Disease (NAFLD) and to explore their associations with pediatric cardiometabolic risk factors. We conducted a cross-sectional study on 68 pediatric obese and overweight (O&O) patients. Ten healthy controls were recruited. Serum Lumican and Endocan levels were analyzed using ELISA kits. O&O patients had lower levels of Endocan compared to healthy controls (p<0.001). There were no differences between serum Endocan levels in O&O patients with NAFLD and those without (p=0.53). Patients considered having Nonalcoholic Steatohepatitis (NASH) had lower Endocan levels compared to O&O patients without NASH (p=0.026). Patients with metabolic syndrome had lower levels of Endocan (p=0.003). There were no significant differences between serum Lumican levels in O&O children compared to healthy controls. Lumican levels were higher in patients with hypertension (p=0.04). In O&O patients, Lumican levels were negatively correlated with Endocan levels (r=−0.37, p=0.002). Endocan seems a promising biomarker for the evaluation of pediatric NASH. Lumican was not confirmed as a biomarker for NAFLD in our cohort but was associated with higher arterial pressure. Low Endocan levels are accompanied by high serum Lumican levels, and this could be an early signature of cardiometabolic risk.