Nonalcoholic fatty liver disease, liver fibrosis, and cardiometabolic risk factors in adolescence: a Cross-sectional study of 1874 general population adolescents

Lawlor, D. A., Callaway, M., Macdonald-Wallis, C., Anderson, E., Fraser, A., Howe, L. D., Day, C. and Sattar, N. (2014) Nonalcoholic fatty liver disease, liver fibrosis, and cardiometabolic risk factors in adolescence: a Cross-sectional study of 1874 general population adolescents. Journal of Clinical Endocrinology and Metabolism, 99(3), E410-E417. (doi:10.1210/jc.2013-3612) (PMID:24471572) (PMCID:PMC3955251)

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Abstract

Context:

The impact of adolescent nonalcoholic fatty liver disease (NAFLD) on health, independent of fat mass, is unclear.

Objective:

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.

Design:

This was a cross-sectional analysis in participants from a UK birth cohort.

Participants:

One thousand eight hundred seventy-four (1059 female) individuals of a mean age of 17.9 years participated in the study.

Main Outcomes:

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.

Results:

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.

Conclusion:

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Sattar, Professor Naveed
Authors: Lawlor, D. A., Callaway, M., Macdonald-Wallis, C., Anderson, E., Fraser, A., Howe, L. D., Day, C., and Sattar, N.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Journal of Clinical Endocrinology and Metabolism
Publisher:Endocrine Society
ISSN:0021-972X
ISSN (Online):1945-7197

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
494152The utility of biomarkers for non-alcoholic fatty liver disease in adolescentsNaveed SattarMedical Research Council (MRC)G0801456/88195RI CARDIOVASCULAR & MEDICAL SCIENCES