Association of the Components of the Metabolic Syndrome with Non-alcoholic Fatty Liver Disease Among Normal-weight, Overweight and Obese Children and Adolescents

Overview

Journal Diabetol Metab Syndr

Publisher Biomed Central

Specialty Endocrinology

Date 2009 Dec 24

PMID 20028551

Citations 34

Authors

Roya Kelishadi

Stephen R Cook

Atoosa Adibi

Zahra Faghihimani

Shohreh Ghatrehsamani

Abolfazl Beihaghi

Hamidreza Salehi

Noushin Khavarian

Parinaz Poursafa

Affiliations

Soon will be listed here.

Abstract

Objectives: This study aimed to determine the prevalence of the metabolic syndrome, abnormalities of liver enzymes and sonographic fatty liver, as well as the inter-related associations in normal weight, overweight and obese children and adolescents.

Methods: This cross-sectional study was conducted among a sample of 1107 students (56.1% girls), aged 6-18 years in Isfahan, Iran. In addition to physical examination, fasting blood glucose, serum lipid profile and liver enzymes were determined. Liver sonography was performed among 931 participants. These variables were compared among participants with different body mass index (BMI) categories.

Results: From lower to higher BMI category, alanine aminotransferase (ALT), total cholesterol, LDL-cholesterol, triglycerides and systolic blood pressure increased, and HDL-cholesterol decreased significantly. Elevated ALT, aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were documented in respectively 4.1%, 6.6% and 9.8% of normal weight group. The corresponding figure was 9.5%, 9.8% and 9.1% in overweight group, and 16.9%, 14.9% and 10.8% in obese group, respectively. In all BMI categories, ALT increased significantly by increasing the number of the components of the metabolic syndrome. Odds ratio for elevated liver enzymes and sonographic fatty liver increased significantly with higher number of the components of the metabolic syndrome and higher BMI categories before and after adjustment for age.

Conclusions: Because of the interrelationship of biochemical and sonographic indexes of fatty liver with the components of the metabolic syndrome, and with increase in their number, it is suggested to determine the clinical impact of such association in future longitudinal studies.

Citing Articles

The Role of Aspartate Transaminase to Platelet Ratio Index (APRI) for the Prediction of Non-Alcoholic Fatty Liver Disease (NAFLD) in Severely Obese Children and Adolescents.

Rigamonti A, Bondesan A, Rondinelli E, Cella S, Sartorio A Metabolites. 2022; 12(2).

PMID: 35208229 PMC: 8879448. DOI: 10.3390/metabo12020155.

Association of Alanine Aminotransferase With Different Metabolic Phenotypes of Obesity in Children and Adolescents: The CASPIAN-V Study.

Kelishadi R, Hemati Z, Qorbani M, Motlagh M, Djalalinia S, Ahadi Z Front Endocrinol (Lausanne). 2020; 11:358.

PMID: 32849256 PMC: 7426651. DOI: 10.3389/fendo.2020.00358.

Prevalence and risk factors for nonalcoholic fatty liver disease in obese children in rural Punjab, India.

Gupta N, Jindal G, Nadda A, Bansal S, Gahukar S, Kumar A J Family Community Med. 2020; 27(2):103-108.

PMID: 32831555 PMC: 7415271. DOI: 10.4103/jfcm.JFCM_287_19.

Revision of serum ALT upper limits of normal facilitates assessment of mild liver injury in obese children with non-alcoholic fatty liver disease.

Lu Y, Wang Q, Yu L, Yin X, Yang H, Xu X J Clin Lab Anal. 2020; 34(7):e23285.

PMID: 32267017 PMC: 7370732. DOI: 10.1002/jcla.23285.

NAFLD in children: new genes, new diagnostic modalities and new drugs.

Nobili V, Alisi A, Valenti L, Miele L, Feldstein A, Alkhouri N Nat Rev Gastroenterol Hepatol. 2019; 16(9):517-530.

PMID: 31278377 DOI: 10.1038/s41575-019-0169-z.

References

Taylor R, Jones I, Williams S, Goulding A . Evaluation of waist circumference, waist-to-hip ratio, and the conicity index as screening tools for high trunk fat mass, as measured by dual-energy X-ray absorptiometry, in children aged 3-19 y. Am J Clin Nutr. 2000; 72(2):490-5. DOI: 10.1093/ajcn/72.2.490. View

Schwimmer J, Deutsch R, Rauch J, Behling C, Newbury R, Lavine J . Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. J Pediatr. 2003; 143(4):500-5. DOI: 10.1067/S0022-3476(03)00325-1. View

Katzmarzyk P, Srinivasan S, Chen W, Malina R, Bouchard C, Berenson G . Body mass index, waist circumference, and clustering of cardiovascular disease risk factors in a biracial sample of children and adolescents. Pediatrics. 2004; 114(2):e198-205. DOI: 10.1542/peds.114.2.e198. View

Roberts E . Non-alcoholic fatty liver disease (NAFLD) in children. Front Biosci. 2005; 10:2306-18. DOI: 10.2741/1699. View

Marchesini G, Brizi M, Morselli-Labate A, Bianchi G, Bugianesi E, McCullough A . Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med. 1999; 107(5):450-5. DOI: 10.1016/s0002-9343(99)00271-5. View

Burgert T, Taksali S, Dziura J, Goodman T, Yeckel C, Papademetris X . Alanine aminotransferase levels and fatty liver in childhood obesity: associations with insulin resistance, adiponectin, and visceral fat. J Clin Endocrinol Metab. 2006; 91(11):4287-94. DOI: 10.1210/jc.2006-1010. View

Kuczmarski R, Ogden C, Grummer-Strawn L, Flegal K, Guo S, Wei R . CDC growth charts: United States. Adv Data. 2001; (314):1-27. View

Bruce K, Byrne C . The metabolic syndrome: common origins of a multifactorial disorder. Postgrad Med J. 2009; 85(1009):614-21. DOI: 10.1136/pgmj.2008.078014. View

Kelishadi R, Ardalan G, Gheiratmand R, Gouya M, Mohammad Razaghi E, Delavari A . Association of physical activity and dietary behaviours in relation to the body mass index in a national sample of Iranian children and adolescents: CASPIAN Study. Bull World Health Organ. 2007; 85(1):19-26. PMC: 2636217. DOI: 10.2471/blt.06.030783. View

10.

Ciba I, Widhalm K . The association between non-alcoholic fatty liver disease and insulin resistance in 20 obese children and adolescents. Acta Paediatr. 2006; 96(1):109-12. DOI: 10.1111/j.1651-2227.2007.00031.x. View

11.

Moreno L, Pineda I, Rodriguez G, Fleta J, Sarria A, Bueno M . Waist circumference for the screening of the metabolic syndrome in children. Acta Paediatr. 2003; 91(12):1307-12. DOI: 10.1080/08035250216112. View

12.

Kelishadi R . Childhood overweight, obesity, and the metabolic syndrome in developing countries. Epidemiol Rev. 2007; 29:62-76. DOI: 10.1093/epirev/mxm003. View

13.

Zimmet P, Alberti K, Kaufman F, Tajima N, Silink M, Arslanian S . The metabolic syndrome in children and adolescents - an IDF consensus report. Pediatr Diabetes. 2007; 8(5):299-306. DOI: 10.1111/j.1399-5448.2007.00271.x. View

14.

Chan D, Li A, Chu W, Chan M, Wong E, Liu E . Hepatic steatosis in obese Chinese children. Int J Obes Relat Metab Disord. 2004; 28(10):1257-63. DOI: 10.1038/sj.ijo.0802734. View

15.

Lee S, Bacha F, Gungor N, Arslanian S . Comparison of different definitions of pediatric metabolic syndrome: relation to abdominal adiposity, insulin resistance, adiponectin, and inflammatory biomarkers. J Pediatr. 2008; 152(2):177-84. DOI: 10.1016/j.jpeds.2007.07.053. View

16.

Baldridge A, Perez-Atayde A, Graeme-Cook F, Higgins L, Lavine J . Idiopathic steatohepatitis in childhood: a multicenter retrospective study. J Pediatr. 1995; 127(5):700-4. DOI: 10.1016/s0022-3476(95)70156-7. View

17.

Mager D, Roberts E . Nonalcoholic fatty liver disease in children. Clin Liver Dis. 2005; 10(1):109-31, vi-vii. DOI: 10.1016/j.cld.2005.10.007. View

18.

Strauss R, Barlow S, Dietz W . Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents. J Pediatr. 2000; 136(6):727-33. View

19.

Hanley A, Williams K, Festa A, Wagenknecht L, DAgostino Jr R, Kempf J . Elevations in markers of liver injury and risk of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes. 2004; 53(10):2623-32. DOI: 10.2337/diabetes.53.10.2623. View

20.

Yoo J, Lee S, Kim K, Yoo S, Sung E, Yim J . Relationship between insulin resistance and serum alanine aminotransferase as a surrogate of NAFLD (nonalcoholic fatty liver disease) in obese Korean children. Diabetes Res Clin Pract. 2008; 81(3):321-6. DOI: 10.1016/j.diabres.2008.05.006. View