Objectives: We have previously demonstrated associations between the macrophage activation marker soluble (s)CD163 and histology of non-alcoholic fatty liver disease (NAFLD) in adults, and elevated sCD163 levels in obese children with NAFLD. However, macrophage activation has not been investigated in children with biopsy-proven NAFLD, which was the objective of the present study. Methods: We used in-house ELISAs to measure sCD163 and the novel macrophage marker soluble mannose receptor (sMR) in a cross-sectional (n = 155) pediatric NAFLD cohort, and a cohort of NAFLD children (n = 36) undergoing a randomized trial by the probiotic VSL#3. We included 56 healthy non-obese children for comparison. Results: Levels of sCD163 and sMR were higher in both of the NAFLD cohorts compared with controls (p
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