The macrophage activation marker s CD 163 is associated with changes in NAFLD and metabolic profile during lifestyle intervention in obese children

Summary Background Obesity is associated with metabolic derangement and non‐alcoholic fatty liver disease ( NAFLD ). Macrophages are involved in liver inflammation and fibrosis, and soluble (s) CD 163 is a macrophage activation marker. Objectives To associate s CD 163 with parameters of paediatric obesity and NAFLD , as well as changes in these parameters during lifestyle intervention. Methods We studied 117 obese children during a 10‐week lifestyle intervention; 71 completed the 12‐month follow‐up. We recorded clinical and biochemical data, and performed liver ultrasonography. Results Baseline s CD 163 was higher in children with elevated alanine transaminase ( ALT ) (2.3 ± 0.7 vs. 2.0 ± 0.6 mg L −1 , P  = 0.03), steatosis (2.3 ± 0.7 vs. 2.0 ± 0.6 mg L −1 , P  = 0.01) and high paediatric NAFLD fibrosis index (2.3 ± 0.7 vs. 1.9 ± 0.6 mg L −1 , P  = 0.03). Baseline s CD 163 was independently associated with ALT , cholesterol and high‐sensitivity C ‐reactive protein (hs‐ CRP ). The change in s CD 163 during lifestyle intervention was associated with changes in ALT , homeostatic model assessment of insulin resistance ( HOMA ‐ IR ), hs‐ CRP and cholesterol, and inversely associated with the change in high‐density lipoprotein cholesterol. Conclusion s CD 163 was associated with markers of liver injury and metabolic parameters in obese children, and changes in these parameters during lifestyle intervention. This may suggest that activated macrophages play a role in NAFLD and s CD 163 may serve as a marker of liver disease severity and treatment effect.