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Non-alcoholic fatty liver disease: An early mediator predicting metabolic syndrome in obese children?
World J Gastroenterol 2011; 17(6):735-42WJ

Abstract

AIM

To investigate if non-alcoholic fatty liver disease (NAFLD) is an early mediator for prediction of metabolic syndrome, and if liver B-ultrasound can be used for its diagnosis.

METHODS

We classified 861 obese children (6-16 years old) into three subgroups: group 0 (normal liver in ultrasound and normal transaminases); group 1 (fatty liver in ultrasound and normal transaminases); and group 2 (fatty liver in ultrasound and elevated transaminases). We measured the body mass index, waist and hip circumference, blood pressure, fasting blood glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), whole-body insulin sensitivity index (WBISI), lipid profile and transaminases in all the participants. The risk of developing metabolic syndrome (MS) was assessed according to the degree of liver fatty infiltration based on the B-ultrasound examination.

RESULTS

Among the 861 obese children, 587 (68.18%) were classified as having NAFLD, and 221 (25.67%) as having MS. The prevalence of MS in NAFLD children (groups 1 and 2) was 37.64% (221/587), which was much higher than that in non-NAFLD group (group 0, 12.04%) (P < 0.01). There were significantly higher incidences concerning every component of MS in group 2 compared with group 0 (P < 0.05). The incidence of NAFLD in MS patients was 84.61% (187/221), which was significantly higher than that of hypertension (57.46%, 127/221) and glucose metabolic anomalies (22.62%, 50/221), and almost equal to the prevalence of dyslipidemia (89.14%, 197/221). Based on the B-ultrasound scales, the presence of moderate and severe liver fatty infiltration carried a high risk of hypertension [odds ratio (OR): 2.18, 95% confidence interval (95% CI): 1.27-3.75], dyslipidemia (OR: 7.99, 95% CI: 4.34-14.73), impaired fasting glucose (OR: 3.65, 95% CI: 1.04-12.85), and whole MS (OR: 3.77; 95% CI: 1.90-7.47, P < 0.01). The state of insulin resistance (calculated by HOMA-IR and WBISI) deteriorated as the degree of fatty infiltration increased.

CONCLUSION

NAFLD is not only a liver disease, but also an early mediator that reflects metabolic disorder, and liver B-ultrasound can be a useful tool for MS screening.

Authors+Show Affiliations

Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China. fjf68@yahoo.com.cnNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21390143

Citation

Fu, Jun-Fen, et al. "Non-alcoholic Fatty Liver Disease: an Early Mediator Predicting Metabolic Syndrome in Obese Children?" World Journal of Gastroenterology, vol. 17, no. 6, 2011, pp. 735-42.
Fu JF, Shi HB, Liu LR, et al. Non-alcoholic fatty liver disease: An early mediator predicting metabolic syndrome in obese children? World J Gastroenterol. 2011;17(6):735-42.
Fu, J. F., Shi, H. B., Liu, L. R., Jiang, P., Liang, L., Wang, C. L., & Liu, X. Y. (2011). Non-alcoholic fatty liver disease: An early mediator predicting metabolic syndrome in obese children? World Journal of Gastroenterology, 17(6), pp. 735-42. doi:10.3748/wjg.v17.i6.735.
Fu JF, et al. Non-alcoholic Fatty Liver Disease: an Early Mediator Predicting Metabolic Syndrome in Obese Children. World J Gastroenterol. 2011 Feb 14;17(6):735-42. PubMed PMID: 21390143.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-alcoholic fatty liver disease: An early mediator predicting metabolic syndrome in obese children? AU - Fu,Jun-Fen, AU - Shi,Hong-Bo, AU - Liu,Li-Rui, AU - Jiang,Ping, AU - Liang,Li, AU - Wang,Chun-Lin, AU - Liu,Xi-Yong, PY - 2010/07/20/received PY - 2010/09/06/revised PY - 2010/09/13/accepted PY - 2011/3/11/entrez PY - 2011/3/11/pubmed PY - 2011/7/19/medline KW - Childhood obesity KW - Liver B ultrasonography KW - Metabolic syndrome KW - Non-alcoholic fatty liver disease SP - 735 EP - 42 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 17 IS - 6 N2 - AIM: To investigate if non-alcoholic fatty liver disease (NAFLD) is an early mediator for prediction of metabolic syndrome, and if liver B-ultrasound can be used for its diagnosis. METHODS: We classified 861 obese children (6-16 years old) into three subgroups: group 0 (normal liver in ultrasound and normal transaminases); group 1 (fatty liver in ultrasound and normal transaminases); and group 2 (fatty liver in ultrasound and elevated transaminases). We measured the body mass index, waist and hip circumference, blood pressure, fasting blood glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), whole-body insulin sensitivity index (WBISI), lipid profile and transaminases in all the participants. The risk of developing metabolic syndrome (MS) was assessed according to the degree of liver fatty infiltration based on the B-ultrasound examination. RESULTS: Among the 861 obese children, 587 (68.18%) were classified as having NAFLD, and 221 (25.67%) as having MS. The prevalence of MS in NAFLD children (groups 1 and 2) was 37.64% (221/587), which was much higher than that in non-NAFLD group (group 0, 12.04%) (P < 0.01). There were significantly higher incidences concerning every component of MS in group 2 compared with group 0 (P < 0.05). The incidence of NAFLD in MS patients was 84.61% (187/221), which was significantly higher than that of hypertension (57.46%, 127/221) and glucose metabolic anomalies (22.62%, 50/221), and almost equal to the prevalence of dyslipidemia (89.14%, 197/221). Based on the B-ultrasound scales, the presence of moderate and severe liver fatty infiltration carried a high risk of hypertension [odds ratio (OR): 2.18, 95% confidence interval (95% CI): 1.27-3.75], dyslipidemia (OR: 7.99, 95% CI: 4.34-14.73), impaired fasting glucose (OR: 3.65, 95% CI: 1.04-12.85), and whole MS (OR: 3.77; 95% CI: 1.90-7.47, P < 0.01). The state of insulin resistance (calculated by HOMA-IR and WBISI) deteriorated as the degree of fatty infiltration increased. CONCLUSION: NAFLD is not only a liver disease, but also an early mediator that reflects metabolic disorder, and liver B-ultrasound can be a useful tool for MS screening. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/21390143/Non_alcoholic_fatty_liver_disease:_An_early_mediator_predicting_metabolic_syndrome_in_obese_children L2 - http://www.wjgnet.com/1007-9327/full/v17/i6/735.htm DB - PRIME DP - Unbound Medicine ER -