Bart G P Koot1, Eric de Groot2,3, Olga H van der Baan-Slootweg4, Anneloes E Bohte5, Aart J Nederveen5, Peter L M Jansen6, Jaap Stoker5, Marc A Benninga1. 1. Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands. 2. Department of Cardiology and Cardio-Thoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands. 3. Imagelabonline and Cardiovascular, Matrix II, Science Park, Amsterdam, The Netherlands. 4. Childhood Obesity Center Heideheuvel, Hilversum, The Netherlands. 5. Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands. 6. Department of Hepatology, Academic Medical Center, Amsterdam, The Netherlands.
Abstract
OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has been recognized as an independent risk factor for cardiovascular disease in adults. It has not been established whether NAFLD is related to early atherosclerotic changes in children. METHODS: In a cross-sectional study, 78 non diabetic, non smoking children with severe obesity were evaluated for NAFLD. Proton magnetic resonance spectroscopy was used to detect liver steatosis and serum ALT was used as a surrogate marker for steatohepatitis. Carotid intima-media thickness (CIMT) and arterial wall stiffness were measured using ultrasound. RESULTS: Steatosis was present in 41 (53%) of subjects. Of these children, 26 out of 41 (63%) had elevated ALT levels. No differences in CIMT and arterial wall stiffness were observed between those without and with steatosis and those with steatosis plus elevated ALT levels [CIMT = 0.47 (±0.06), 0.48 (±0.06) and 0.48 (±0.07) mm, respectively; stiffness = 2.78 (±0.50), 3.00 (±0.81), and 2.90 (±0.78), respectively]. Steatosis and ALT were not correlated to CIMT (r = -0.02 and -0.14, respectively) or arterial wall stiffness (r = 0.13 and -0.11, respectively). CONCLUSIONS: In this study, no relationship between NAFLD and early atherosclerotic changes in children was observed. An atherogenic effect of steatohepatitis (NASH) on pediatric age and long-term atherogenic consequences of simple steatosis cannot be excluded based on this study.
OBJECTIVE:Nonalcoholic fatty liver disease (NAFLD) has been recognized as an independent risk factor for cardiovascular disease in adults. It has not been established whether NAFLD is related to early atherosclerotic changes in children. METHODS: In a cross-sectional study, 78 non diabetic, non smoking children with severe obesity were evaluated for NAFLD. Proton magnetic resonance spectroscopy was used to detect liver steatosis and serum ALT was used as a surrogate marker for steatohepatitis. Carotid intima-media thickness (CIMT) and arterial wall stiffness were measured using ultrasound. RESULTS:Steatosis was present in 41 (53%) of subjects. Of these children, 26 out of 41 (63%) had elevated ALT levels. No differences in CIMT and arterial wall stiffness were observed between those without and with steatosis and those with steatosis plus elevated ALT levels [CIMT = 0.47 (±0.06), 0.48 (±0.06) and 0.48 (±0.07) mm, respectively; stiffness = 2.78 (±0.50), 3.00 (±0.81), and 2.90 (±0.78), respectively]. Steatosis and ALT were not correlated to CIMT (r = -0.02 and -0.14, respectively) or arterial wall stiffness (r = 0.13 and -0.11, respectively). CONCLUSIONS: In this study, no relationship between NAFLD and early atherosclerotic changes in children was observed. An atherogenic effect of steatohepatitis (NASH) on pediatric age and long-term atherogenic consequences of simple steatosis cannot be excluded based on this study.
Authors: Fida Bacha; Anca Tomsa; Sara K Bartz; Sarah E Barlow; Zili David Chu; Ramkumar Krishnamurthy; Rajesh Krishnamurthy; E O'Brian Smith Journal: J Endocr Soc Date: 2017-06-27
Authors: Qu Bao-Ge; Wang Hui; Jia Yi-Guo; Su Ji-Liang; Wang Zhong-Dong; Wang Ya-Fei; Han Xing-Hai; Liu Yuan-Xun; Pan Jin-Dun; Ren Guang-Ying Journal: Sci Rep Date: 2017-02-21 Impact factor: 4.379