Insulin resistance and the metabolic syndrome are related to the severity of steatosis in the pediatric population with obesity

• Published in: Revista española de enfermedades digestivas Vol. 109; no. 11; pp. 772 - 777
• Main Authors: Ubiña-Aznar, Esther, Tapia-Ceballos, Leopoldo, Rosales-Zabal, José Miguel, Porcel-Chacón, Rocío, Poveda-Gómez, Francisco, Lozano-Calero, Carmen, Ortiz-Cuevas, Carmen, Rivas-Ruiz, Francisco, Sánchez Cantos, Andrés, Navarro Jarabo, José María
• Format: Journal Article
• Language: English
• Published: Spain Sociedad Española de Patología Digestiva 01.11.2017; Aran Ediciones
• Subjects: Adolescent; Child; Cohort Studies; Cross-Sectional Studies; Fatty Liver - etiology; Fatty Liver - metabolism; Fatty Liver - pathology; Female; Gastroenterology & Hepatology; Geriatrics & Gerontology; Humans; Infectious Diseases; Insulin Resistance; Liver steatosis; Male; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Metabolic Syndrome - pathology; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Oncology; Pathology; Pediatric obesity; Pediatric Obesity - complications; Pediatric Obesity - epidemiology; Pediatric Obesity - pathology; Pharmacology & Pharmacy; Prevalence; Radiology, Nuclear Medicine & Medical Imaging; Risk Factors; Surgery; Insulin resistance; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Metabolic syndrome; Pediatric obesity; Liver steatosis
• ISSN: 1130-0108
• DOI: 10.17235/reed.2017.4898/2017

To determine the factors associated with an increased risk for severe steatosis (SS) and establish the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) as a screening tool. A cross-sectional study was performed in obese children to assess the relationship between the metabolic syndrome (MetS) and glucose metabolism alterations (GMA) and the risk for severe steatosis. A total of 94 children (51 males) aged from six to 14 years were included. Thirteen children (14.8%) had severe steatosis (SS). The anthropometric variables associated with SS included body mass index (BMI) (SS 34.1 vs non-SS 29.7, p = 0.005), waist circumference (cm) (100 vs 92.5, p = 0.015) and hip circumference (cm) (108 vs 100, p = 0.018). The blood parameters included alanine aminotransferase (ALT) (UI/dl) (27 vs 21, p = 0.002), gamma-glutamil transpeptidase (GGT) (UI/dl) (16 vs 15, p = 0.017), fasting glycemia (mg/dl) (96 vs 88, p = 0.006), fasting insulin (UI/dl) (25 vs 15.3, p < 0.001) and HOMA-IR score (7.1 vs 3.7, p < 0.001). Eighteen children with MetS were found to be at an increased risk for severe steatosis (odds ratio [OR] 11.36, p < 0.001). After receiver operating characteristic (ROC) curve analysis, the best area under the curve (AUC) was obtained for HOMA-R of 0.862. The HOMA-R 4.9 cut-off value had a 100% sensitivity (CI 95%: 96.2-100) and 67.9% specificity (CI 95%: 57.1-78.7) for severe steatosis. The presence of MetS and glucose metabolism alterations are risk factors for severe steatosis. The 4.9 cut-off value for HOMA-IR may be a risk factor for severe steatosis in obese children.