BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), the most common cause of liver disease in children, is associated with obesity and insulin resistance. However, the relationship between NAFLD and cardiovascular risk factors in children is not fully understood. The objective of this study was to determine the association between NAFLD and the presence of metabolic syndrome in overweight and obese children. METHODS AND RESULTS: This case-control study of 150 overweight children with biopsy-proven NAFLD and 150 overweight children without NAFLD compared rates of metabolic syndrome using Adult Treatment Panel III criteria. Cases and controls were well matched in age, sex, and severity of obesity. Children with NAFLD had significantly higher fasting glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, triglycerides, systolic blood pressure, and diastolic blood pressure than overweight and obese children without NAFLD. Subjects with NAFLD also had significantly lower high-density lipoprotein cholesterol than controls. After adjustment for age, sex, race, ethnicity, body mass index, and hyperinsulinemia, children with metabolic syndrome had 5.0 (95% confidence interval, 2.6 to 9.7) times the odds of having NAFLD as overweight and obese children without metabolic syndrome. CONCLUSIONS: NAFLD in overweight and obese children is strongly associated with multiple cardiovascular risk factors. The identification of NAFLD in a child should prompt global counseling to address nutrition, physical activity, and avoidance of smoking to prevent the development of cardiovascular disease and type 2 diabetes.
BACKGROUND:Nonalcoholic fatty liver disease (NAFLD), the most common cause of liver disease in children, is associated with obesity and insulin resistance. However, the relationship between NAFLD and cardiovascular risk factors in children is not fully understood. The objective of this study was to determine the association between NAFLD and the presence of metabolic syndrome in overweight and obesechildren. METHODS AND RESULTS: This case-control study of 150 overweight children with biopsy-proven NAFLD and 150 overweight children without NAFLD compared rates of metabolic syndrome using Adult Treatment Panel III criteria. Cases and controls were well matched in age, sex, and severity of obesity. Children with NAFLD had significantly higher fasting glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, triglycerides, systolic blood pressure, and diastolic blood pressure than overweight and obesechildren without NAFLD. Subjects with NAFLD also had significantly lower high-density lipoprotein cholesterol than controls. After adjustment for age, sex, race, ethnicity, body mass index, and hyperinsulinemia, children with metabolic syndrome had 5.0 (95% confidence interval, 2.6 to 9.7) times the odds of having NAFLD as overweight and obesechildren without metabolic syndrome. CONCLUSIONS: NAFLD in overweight and obesechildren is strongly associated with multiple cardiovascular risk factors. The identification of NAFLD in a child should prompt global counseling to address nutrition, physical activity, and avoidance of smoking to prevent the development of cardiovascular disease and type 2 diabetes.
Authors: Christine L Williams; Laura L Hayman; Stephen R Daniels; Thomas N Robinson; Julia Steinberger; Stephen Paridon; Terry Bazzarre Journal: Circulation Date: 2002-07-02 Impact factor: 29.690
Authors: Jeffrey B Schwimmer; Reena Deutsch; Jeffrey B Rauch; Cynthia Behling; Robert Newbury; Joel E Lavine Journal: J Pediatr Date: 2003-10 Impact factor: 4.406
Authors: Ram Weiss; James Dziura; Tania S Burgert; William V Tamborlane; Sara E Taksali; Catherine W Yeckel; Karin Allen; Melinda Lopes; Mary Savoye; John Morrison; Robert S Sherwin; Sonia Caprio Journal: N Engl J Med Date: 2004-06-03 Impact factor: 91.245
Authors: Martha L Cruz; Marc J Weigensberg; Terry T-K Huang; Geoff Ball; Gabriel Q Shaibi; Michael I Goran Journal: J Clin Endocrinol Metab Date: 2004-01 Impact factor: 5.958
Authors: Varman T Samuel; Zhen-Xiang Liu; Xianqin Qu; Benjamin D Elder; Stefan Bilz; Douglas Befroy; Anthony J Romanelli; Gerald I Shulman Journal: J Biol Chem Date: 2004-05-27 Impact factor: 5.157
Authors: Warren L Shapiro; Elizabeth L Yu; Jennifer C Arin; Karen F Murray; Sabina Ali; Nirav K Desai; Stavra A Xanthakos; Henry C Lin; Naim Alkhouri; Reham Abdou; Stephanie H Abrams; Megan W Butler; Sarah A Faasse; Lynette A Gillis; Timothy A Hadley; Ajay K Jain; Marianne Kavan; Kattayoun Kordy; Peter Lee; Jennifer Panganiban; John F Pohl; Carol Potter; Bryan Rudolph; Shikha S Sundaram; Shivali Joshi; James A Proudfoot; Nidhi P Goyal; Kathryn E Harlow; Kimberly P Newton; Jeffrey B Schwimmer Journal: J Pediatr Gastroenterol Nutr Date: 2019-02 Impact factor: 2.839
Authors: Jennifer L Rehm; Peter M Wolfgram; Diego Hernando; Jens C Eickhoff; David B Allen; Scott B Reeder Journal: Eur Radiol Date: 2015-04-28 Impact factor: 5.315
Authors: Lucia Pacifico; Michele Di Martino; Caterina Anania; Gian Marco Andreoli; Mario Bezzi; Carlo Catalano; Claudio Chiesa Journal: World J Gastroenterol Date: 2015-04-21 Impact factor: 5.742
Authors: Amandeep K Sahota; Warren L Shapiro; Kimberly P Newton; Steven T Kim; Joanie Chung; Jeffrey B Schwimmer Journal: Pediatrics Date: 2020-12 Impact factor: 7.124
Authors: Jeffrey B Schwimmer; Joel E Lavine; Laura A Wilson; Brent A Neuschwander-Tetri; Stavra A Xanthakos; Rohit Kohli; Sarah E Barlow; Miriam B Vos; Saul J Karpen; Jean P Molleston; Peter F Whitington; Philip Rosenthal; Ajay K Jain; Karen F Murray; Elizabeth M Brunt; David E Kleiner; Mark L Van Natta; Jeanne M Clark; James Tonascia; Edward Doo Journal: Gastroenterology Date: 2016-08-26 Impact factor: 22.682
Authors: J Hay; K Wittmeier; A MacIntosh; B Wicklow; T Duhamel; E Sellers; H Dean; E Ready; L Berard; D Kriellaars; G X Shen; P Gardiner; J McGavock Journal: Int J Obes (Lond) Date: 2015-11-30 Impact factor: 5.095