Eréndira Villanueva-Ortega1, María José Garcés-Hernández2, Arturo Herrera-Rosas3, Juan Carlos López-Alvarenga4, Estibalitz Laresgoiti-Servitje5, Galileo Escobedo6, Gloria Queipo7, Sergio Cuevas-Covarrubias8, Guadalupe Nayely Garibay-Nieto9. 1. Pediatric Obesity Clinic, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico; School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico. 2. School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico. 3. Clinical Research Department, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico. 4. School of Medicine & South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Edinburg, TX, USA. 5. Clinical Medical Sciences, School of Medicine, Tecnológico de Monterrey, Campus Ciudad de México, Mexico City, Mexico. 6. Experimental Medicine Research Unit, Universidad Nacional Autónoma de México & Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico. 7. School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico; Department of Human Genetics, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico. 8. Department of Human Genetics, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico. 9. Pediatric Obesity Clinic, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico; School of Medicine, Universidad Nacional Autónoma de México, Mexico City, Mexico; Department of Human Genetics, Hospital General de México "Dr. Eduardo Liceaga", Mexico City, Mexico. Electronic address: gngaribay@hotmail.com.
Abstract
INTRODUCTION AND OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and it is more prevalent in Hispanic males. The gender differences can be explained by body fat distribution, lifestyle, or sex hormone metabolism. We evaluated anthropometric and metabolic differences by gender in children with and without NAFLD. METHODS: We included 194 participants (eutrophic, overweight, and individuals with obesity). The presence of NAFLD was determined using ultrasonography, and we evaluated the association between this disease with metabolic and anthropometric variables by gender. RESULTS: The mean age was 10.64±2.54 years. The frequency of NAFLD in boys was 24.51% and in girls was 11.96% (OR=2.39; 95%CI=1.10-5.19; p=0.025). For girls, NAFLD was significantly associated with triglycerides (p=0.012), homeostatic model assessment of insulin resistance (HOMA-IR) (p=0.048), and the visceral adiposity index (VAI) (p=0.024). The variables related to NAFLD in a gender-specific manner were body mass index (BMI) (p=0.001), waist circumference (WC) (p<0.001), HDL cholesterol (p=0.021), alanine aminotransferase (ALT) (p<0.001), and aspartate aminotransferase (AST) (p=0.002). CONCLUSIONS: In our study NAFLD is more frequent in boys, only ALT, and no other clinical or metabolic variables, were associated with NAFLD in these patients. HOMA-IR, VAI, triglyceride levels, and ALT were associated with NAFLD only in girls. The ALT cut-off points for the development of NAFLD in our study were 28.5U/L in females and 27.5U/L in males. Our findings showed that NAFLD should be intentionally screened in patients with obesity, particularly in boys.
INTRODUCTION AND OBJECTIVES:Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and it is more prevalent in Hispanic males. The gender differences can be explained by body fat distribution, lifestyle, or sex hormone metabolism. We evaluated anthropometric and metabolic differences by gender in children with and without NAFLD. METHODS: We included 194 participants (eutrophic, overweight, and individuals with obesity). The presence of NAFLD was determined using ultrasonography, and we evaluated the association between this disease with metabolic and anthropometric variables by gender. RESULTS: The mean age was 10.64±2.54 years. The frequency of NAFLD in boys was 24.51% and in girls was 11.96% (OR=2.39; 95%CI=1.10-5.19; p=0.025). For girls, NAFLD was significantly associated with triglycerides (p=0.012), homeostatic model assessment of insulin resistance (HOMA-IR) (p=0.048), and the visceral adiposity index (VAI) (p=0.024). The variables related to NAFLD in a gender-specific manner were body mass index (BMI) (p=0.001), waist circumference (WC) (p<0.001), HDL cholesterol (p=0.021), alanine aminotransferase (ALT) (p<0.001), and aspartate aminotransferase (AST) (p=0.002). CONCLUSIONS: In our study NAFLD is more frequent in boys, only ALT, and no other clinical or metabolic variables, were associated with NAFLD in these patients. HOMA-IR, VAI, triglyceride levels, and ALT were associated with NAFLD only in girls. The ALT cut-off points for the development of NAFLD in our study were 28.5U/L in females and 27.5U/L in males. Our findings showed that NAFLD should be intentionally screened in patients with obesity, particularly in boys.
Authors: Magda Shaheen; Katrina M Schrode; Deyu Pan; Dulcie Kermah; Vishwajeet Puri; Ali Zarrinpar; David Elisha; Sonia M Najjar; Theodore C Friedman Journal: Front Med (Lausanne) Date: 2021-12-02