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Type: Journal article
Title: Nonalcoholic fatty liver disease, liver fibrosis, and cardiometabolic risk factors in adolescence: a cross- Sectional study of 1874 general population adolescents
Author: Lawlor, D.
Callaway, M.
Macdonald-Wallis, C.
Anderson, E.
Fraser, A.
Howe, L.
Day, C.
Sattar, N.
Citation: Journal of Clinical Endocrinology and Metabolism, 2014; 99(3):E410-E417
Publisher: Endocrine Society
Issue Date: 2014
ISSN: 0021-972X
Statement of
Debbie A. Lawlor, Mark Callaway, Corrie Macdonald-Wallis, Emma Anderson, Abigail Fraser, Laura D. Howe, Chris Day, and Naveed Sattar
Abstract: The impact of adolescent nonalcoholic fatty liver disease (NAFLD) on health, independent of fat mass, is unclear.The objective of the study was to determine the independent (of total body fat) association of ultrasound scan (USS)-determined NAFLD with liver fibrosis, insulin resistance, and dyslipidemia among healthy adolescents.This was a cross-sectional analysis in participants from a UK birth cohort.One thousand eight hundred seventy-four (1059 female) individuals of a mean age of 17.9 years participated in the study.USS assessed liver stiffness (shear velocity, an indicator of fibrosis) and volume, fasting glucose, insulin, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, alanine amino transferase, aspartate amino transferase, γ-glutamyltransferase, and haptoglobin.The prevalence of NAFLD was 2.5% [95% confidence interval (CI) 1.8-3.3] and was the same in females and males. Dual-energy X-ray absorptiometry determined total body fat mass was strongly associated with USS NAFLD: odds ratio 3.15 (95% CI 2.44-4.07) per 1 SD (∼10 kg) fat mass. Those with NAFLD had larger liver volumes and greater shear velocity. They also had higher fasting glucose, insulin, triglycerides, low-density lipoprotein cholesterol, alanine amino transferase, aspartate amino transferase, γ-glutamyltransferase, and haptoglobin and lower high-density lipoprotein cholesterol. Most associations were independent of total body fat. For example, after adjustment for fat mass and other confounders, hepatic shear velocity [mean difference 22.8% (95% CI 15.6-30.5)], triglyceride levels [23.6% (95% CI 6.0-44.2)], and insulin [39.4% (95% CI 10.7-75.5)] were greater in those with NAFLD compared with those without NAFLD.In healthy European adolescents, 2.5% have USS-defined NAFLD. Even after accounting for total body fat, those with NAFLD have more adverse levels of liver fibrosis and cardiometabolic risk factors.
Keywords: ALT, alanine amino transferase; ARFI, acoustic radiation force impulse imaging; AST, aspartate amino transferase; AUDIT, Alcohol Use Disorders Identification Tests; BMI, body mass index; CI, confidence interval; DXA, dual-energy X-ray absorptiometry; GGT, γ-glutamyltransferase; HDLc, high density lipoprotein cholesterol; LDLc, low density lipoprotein cholesterol; NAFLD, nonalcoholic fatty liver disease; OR, odds ratio; USS, ultrasound scan
Description: First Published Online: January 28, 2014
Rights: Copyright © 2014 by the Endocrine Society
RMID: 0030042728
DOI: 10.1210/jc.2013-3612
Appears in Collections:Medicine publications

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