Clinical, Laboratory, and Histologic Correlates of Serum Antinuclear Antibody in Hispanic Pediatric Patients With Nonalcoholic Fatty Liver Disease

Objectives The significance of antinuclear antibody (ANA) positivity in pediatric Hispanic patients with nonalcoholic fatty liver disease (NAFLD) is unknown. Methods ANA status was correlated with clinical, laboratory, and histologic parameters in Hispanic patients with a histologic diagnosis of NAFLD. Results Thirty-eight Hispanic children (27 male and 11 female) underwent liver biopsy at a median age of 12.1 years. Twenty patients (53%) had positive ANAs. The ANA-positive patients had higher fasting insulin levels (median [interquartile range (IQR)], 32.4 [25.4] mu U/mL) and higher insulin resistance (median [Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) IQR], 5.9 [3.1]) than the ANA-negative patients (fasting insulin: median [IQR], 17 [13.9] mu U/mL and median [HOMA-IR IQR], 3.5 [2.6] mu U/mL; P = .05 and .01, respectively). Serum high-density lipoprotein (HDL) cholesterol levels were higher in the ANA-negative patients (median [IQR], 47 [18] mg/dL) than the ANA-positive patients (38 [12] mg/dL) (P = .03). There were no statistical differences in a series of demographic, clinical, laboratory, and histologic parameters between the ANA-positive and the ANA-negative patients. At a median follow-up of 2.6 years, alanine aminotransferase was significantly lower than the baseline levels in both groups. In 1 patient undergoing ANA retesting, the titer had normalized from a baseline of 1:1,280 3.8 years earlier. Conclusions In pediatric Hispanic patients with NAFLD, a positive ANA result is associated with insulin resistance and lower HDL cholesterol levels.