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Nonalcoholic fatty liver disease, liver fibrosis, and cardiometabolic risk factors in adolescence: A cross- Sectional study of 1874 general population adolescents

Lookup NU author(s): Beth Anderson, Professor Chris DayORCiD

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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. Copyright © 2014 by the Endocrine Society.

Publication metadata

Author(s): Lawlor DA, Callaway M, Macdonald-Wallis C, Anderson E, Fraser A, Howe LD, Day C, Sattar N

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Endocrinology and Metabolism

Year: 2014

Volume: 99

Issue: 3

Pages: E410-E417

Print publication date: 01/03/2014

Online publication date: 28/01/2014

Acceptance date: 19/12/2013

ISSN (print): 0021-972X

ISSN (electronic): 1945-7197

Publisher: Endocrine Society

URL: https://doi.org/10.1210/jc.2013-3612

DOI: 10.1210/jc.2013-3612

PubMed id: 24471572

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