Predictors of non-alcoholic fatty liver disease in obese children

• Published in: European journal of clinical nutrition Vol. 61; no. 7; pp. 877 - 883
• Main Authors: Sartorio, A, Del Col, A, Agosti, F, Mazzilli, G, Bellentani, S, Tiribelli, C, Bedogni, G
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing 01.07.2007; Nature Publishing Group
• Subjects: Adolescent; adolescents; Alanine; Alanine transaminase; Aspartate aminotransferase; Biological and medical sciences; biomarkers; blood glucose; Blood Glucose - metabolism; Blood pressure; Body Mass Index; Body size; C-reactive protein; Child; Children; Children & youth; Cholesterol; Clinical nutrition; clinical trials; Continuity (mathematics); Cross-Sectional Studies; Density; disease prevalence; enzyme activity; enzymes; Evaluation; Fatty liver; Fatty Liver - blood; Fatty Liver - diagnostic imaging; Fatty Liver - epidemiology; Fatty Liver - metabolism; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gender; Glucose; Glucose tolerance; Hepatitis; Hepatitis B; High density lipoprotein; Homeostasis; Humans; Insulin; Insulin - blood; Insulin resistance; Lipids - blood; Liver; Liver - enzymology; Liver diseases; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Logistic Models; Low density lipoprotein; Male; Medical sciences; Metabolic diseases; non-alcoholic fatty liver disease; Obesity; Obesity - blood; Obesity - complications; Obesity - metabolism; Other diseases. Semiology; Predictive Value of Tests; Risk Factors; Sex Factors; Teenagers; Transaminases; Triglycerides; Ultrasonography; Uric acid; Italy; Human; Obesity; risk factors; Prevalence; non-alcoholic fatty liver disease; Nutrition; adolescents; Nutrition disorder; Hepatic disease; Epidemiology; children; Non alcoholic steatohepatitis; Adolescent; Risk factor; Digestive diseases; Predictive factor; Child; Public health; Nutritional status
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1602588

Objective: To evaluate predictors of non-alcoholic fatty liver disease (NAFLD) in obese children. Design: Cross-sectional study. Subjects: Two hundred and sixty-eight obese children not consuming alcohol and without hepatitis B or C were consecutively studied at an auxology clinic. Measurements: Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl-transferase (GGT), cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, triglycerides, uric acid, glucose, glucose during oral glucose tolerance testing (OGTT), insulin, insulin during OGTT, insulin resistance as estimated by homeostasis model assessment (HOMA), C-reactive protein (CRP), and systolic and diastolic blood pressure were measured. Fatty liver was diagnosed by ultrasonography using standard criteria. Univariable and multivariable logistic regression was used to evaluate predictors of NAFLD. All predictors except gender and pubertal status were modeled as continuous variables. Results: NAFLD was detected in 44% of obese children. At univariable analysis, male gender, Z-score of body mass index (BMI) (Z-BMI), ALT, AST, GGT, triglycerides, uric acid, glucose, glucose during OGTT, insulin, insulin during OGTT, HOMA, CRP and systolic blood pressure were predictors of NAFLD, whereas HDL-cholesterol and late-pubertal status were predictors of the normal liver. At multivariable analysis, however, only Z-BMI, ALT, uric acid, glucose during OGTT and insulin during OGTT were independent predictors of NAFLD. Conclusion: Z-BMI, ALT, uric acid, glucose during OGTT and insulin during OGTT are independent predictors of NAFLD in Italian obese children, with most of the prediction explained by ALT and Z-BMI.