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Waist circumference correlates with liver fibrosis in children with non-alcoholic steatohepatitis.
Gut. 2008 Sep; 57(9):1283-7.Gut

Abstract

OBJECTIVE

Waist circumference is widely accepted as a risk factor for cardiovascular disease and metabolic syndrome. Non-alcoholic fatty liver disease (NAFLD) is a feature of the metabolic syndrome. A contribution of metabolic syndrome, and especially of waist circumference, to liver fibrosis in children with NAFLD is strongly suspected.

DESIGN

Cross-sectional study.

SETTING

Department of Hepatogastroenterology and Nutrition, Paediatric Hospital "Bambino Gesù", Rome, Italy.

PATIENTS

197 consecutive Caucasian children with NAFLD (136 males and 61 females) aged 3-19 years.

MAIN OUTCOME MEASURES

Multivariable logistic regression models were used to examine the contribution of gender, age, body mass index (BMI) and metabolic syndrome components (waist circumference, high-density lipoprotein (HDL)-cholesterol, triglycerides, blood pressure and glucose) to the odds of liver fibrosis as detected by liver biopsy.

RESULTS

92% of the children had BMI > or = 85(th) percentile and 84% had a waist > or = 90(th) percentile for gender and age. Ten per cent of the children had metabolic syndrome and 67% had liver fibrosis, mostly of low degree. At multivariable analysis, waist was the only metabolic syndrome component to be associated with liver fibrosis. This was seen both when the components of the metabolic syndrome were coded as dichotomous (odds ratio (OR) = 2.40; 95% confidence interval (CI), 1.04 to 5.54) and continuous (OR = 2.07; 95% CI, 1.43 to 2.98 for a 5 cm increase). In the latter case, age was also associated with the outcome (OR = 0.70; 95% CI, 0.55 to 0.89 for a 1 year increase).

CONCLUSIONS

Abdominal rather than generalised obesity contributes to liver fibrosis in children with NAFLD. Waist is also the only component of the metabolic syndrome to be associated with fibrosis in these children. Therefore, the presence of abdominal obesity is an additional criterion for the selection of children and adolescents who should undergo extensive investigation, including liver biopsy.

Authors+Show Affiliations

Department of Hepatogastroenterology and Nutrition, Paediatric Hospital Bambino Gesù, IRCCS, Rome, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18218674

Citation

Manco, M, et al. "Waist Circumference Correlates With Liver Fibrosis in Children With Non-alcoholic Steatohepatitis." Gut, vol. 57, no. 9, 2008, pp. 1283-7.
Manco M, Bedogni G, Marcellini M, et al. Waist circumference correlates with liver fibrosis in children with non-alcoholic steatohepatitis. Gut. 2008;57(9):1283-7.
Manco, M., Bedogni, G., Marcellini, M., Devito, R., Ciampalini, P., Sartorelli, M. R., Comparcola, D., Piemonte, F., & Nobili, V. (2008). Waist circumference correlates with liver fibrosis in children with non-alcoholic steatohepatitis. Gut, 57(9), 1283-7. https://doi.org/10.1136/gut.2007.142919
Manco M, et al. Waist Circumference Correlates With Liver Fibrosis in Children With Non-alcoholic Steatohepatitis. Gut. 2008;57(9):1283-7. PubMed PMID: 18218674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Waist circumference correlates with liver fibrosis in children with non-alcoholic steatohepatitis. AU - Manco,M, AU - Bedogni,G, AU - Marcellini,M, AU - Devito,R, AU - Ciampalini,P, AU - Sartorelli,M R, AU - Comparcola,D, AU - Piemonte,F, AU - Nobili,V, Y1 - 2008/01/24/ PY - 2008/1/26/pubmed PY - 2008/9/5/medline PY - 2008/1/26/entrez SP - 1283 EP - 7 JF - Gut JO - Gut VL - 57 IS - 9 N2 - OBJECTIVE: Waist circumference is widely accepted as a risk factor for cardiovascular disease and metabolic syndrome. Non-alcoholic fatty liver disease (NAFLD) is a feature of the metabolic syndrome. A contribution of metabolic syndrome, and especially of waist circumference, to liver fibrosis in children with NAFLD is strongly suspected. DESIGN: Cross-sectional study. SETTING: Department of Hepatogastroenterology and Nutrition, Paediatric Hospital "Bambino Gesù", Rome, Italy. PATIENTS: 197 consecutive Caucasian children with NAFLD (136 males and 61 females) aged 3-19 years. MAIN OUTCOME MEASURES: Multivariable logistic regression models were used to examine the contribution of gender, age, body mass index (BMI) and metabolic syndrome components (waist circumference, high-density lipoprotein (HDL)-cholesterol, triglycerides, blood pressure and glucose) to the odds of liver fibrosis as detected by liver biopsy. RESULTS: 92% of the children had BMI > or = 85(th) percentile and 84% had a waist > or = 90(th) percentile for gender and age. Ten per cent of the children had metabolic syndrome and 67% had liver fibrosis, mostly of low degree. At multivariable analysis, waist was the only metabolic syndrome component to be associated with liver fibrosis. This was seen both when the components of the metabolic syndrome were coded as dichotomous (odds ratio (OR) = 2.40; 95% confidence interval (CI), 1.04 to 5.54) and continuous (OR = 2.07; 95% CI, 1.43 to 2.98 for a 5 cm increase). In the latter case, age was also associated with the outcome (OR = 0.70; 95% CI, 0.55 to 0.89 for a 1 year increase). CONCLUSIONS: Abdominal rather than generalised obesity contributes to liver fibrosis in children with NAFLD. Waist is also the only component of the metabolic syndrome to be associated with fibrosis in these children. Therefore, the presence of abdominal obesity is an additional criterion for the selection of children and adolescents who should undergo extensive investigation, including liver biopsy. SN - 1468-3288 UR - https://www.unboundmedicine.com/medline/citation/18218674/Waist_circumference_correlates_with_liver_fibrosis_in_children_with_non_alcoholic_steatohepatitis_ L2 - https://gut.bmj.com/lookup/pmidlookup?view=long&pmid=18218674 DB - PRIME DP - Unbound Medicine ER -