Evaluation of Serum Glucagon Like Peptide-2 in Children with Chronic Liver Diseases

Background: Chronic liver disease (CLD) in children is a significant cause of morbidity and mortality, often leading to complications such as osteoporosis due to nutritional, metabolic, and hormonal factors and intestinal dysbiosis. Glucagon-like peptide-2 (GLP-2), primarily expressed in the ileum, has gained attention for its potential role in bone metabolism. Aim of the study: This study aimed to evaluate serum GLP-2 levels in children with CLD and explore its association with liver disease severity and osteoporosis. Patients and methods: A comparative cross-sectional study, which included 30 pediatric CLD patients and 30 age- and sex-matched apparently healthy controls. Serum GLP-2 levels were measured using an ELISA kit, and bone mineral density (BMD) was assessed using a DEXA scan. Liver fibrosis was scored histologically, and liver disease severity was assessed by MELD, PELD, and Child-Pugh scores. Results: Serum GLP-2 levels were significantly lower in CLD patients (179.9 ± 91.5 Pg/ml) compared to controls (426.64 ± 133.72 Pg/ml; P < 0.001). GLP-2 levels negatively correlated with liver enzyme levels (AST, ALP, GGT; P < 0.05) and positively with BMD (r = 0.414, P = 0.023). The ROC curve revealed a serum GLP-2 cutoff of ≤ 268 Pg/ml, yielding 93.3% sensitivity and 90% specificity for diagnosing CLD. Conclusion: Serum GLP-2 may serve as a non-invasive biomarker for liver fibrosis and osteoporosis in pediatric CLD patients. Further research to confirm its diagnostic utility is needed.