Gender-specific differences in adipose distribution and adipocytokines influence adolescent nonalcoholic fatty liver disease

Authors

  • Oyekoya T. Ayonrinde,

    Corresponding author
    1. School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
    2. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia
    3. Department of Gastroenterology and Hepatology, Fremantle Hospital, Fremantle, Western Australia, Australia
    4. Curtin Health Innovation Research Institute, Bentley, Western Australia, Australia
    • School of Medicine and Pharmacology, Fremantle Hospital, P.O. Box 480, Fremantle, Western Australia, Australia 6959===

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    • fax: +618 94313160

  • John K. Olynyk,

    1. School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
    2. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia
    3. Department of Gastroenterology and Hepatology, Fremantle Hospital, Fremantle, Western Australia, Australia
    4. Curtin Health Innovation Research Institute, Bentley, Western Australia, Australia
    5. Western Australian Institute of Medical Research, Nedlands, Western Australia, Australia
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  • Lawrence J. Beilin,

    1. School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
    2. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia
    3. Royal Perth Hospital, Perth, Western Australia, Australia
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  • Trevor A. Mori,

    1. School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
    2. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia
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  • Craig E. Pennell,

    1. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia
    2. School of Women's and Infants Health, University of Western Australia, Crawley, Western Australia, Australia
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  • Nicholas de Klerk,

    1. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia
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  • Wendy H. Oddy,

    1. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia
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  • Peter Shipman,

    1. Department of Radiology, Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia
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  • Leon A. Adams

    1. School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
    2. Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Subiaco, Western Australia, Australia
    3. Liver Transplantation Unit, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
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    • This work was supported by the National Health and Medical Research Council [through program grants (353514, 403981, and 634445), a postgraduate scholarship to Oyekoya T. Ayonrinde (404166), and a practitioner fellowship to John K. Olynyk (513761)], the Gastroenterology Society of Australia (through the Astra Zeneca Career Development Award to Leon A. Adams), and the Fremantle Hospital Medical Research Foundation (through a medical research grant).


  • Potential conflict of interest: Nothing to report.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a predominantly adult-diagnosed disorder. Knowledge regarding the epidemiology, phenotype, and metabolic risk factors, during adolescence is limited. We sought to determine the prevalence, phenotype, and predictors of NAFLD in 1170 community-based adolescents in the Western Australian Pregnancy Cohort (Raine) Study (the Raine Cohort) who underwent a cross-sectional assessment that included questionnaires, anthropometry, cardiovascular examinations, blood tests, and abdominal ultrasound examinations. Among the 1170 adolescents assessed, the prevalence of NAFLD was 12.8%. Females compared with males had a significantly higher prevalence of NAFLD (16.3% versus 10.1%, P = 0.004) and central obesity (33.2% versus 9.9%, P < 0.05). The severity of hepatic steatosis was associated with the body mass index, waist circumference, subcutaneous adipose tissue thickness (SAT), serum leptin level, homeostasis model assessment for insulin resistance score (P < 0.001 for all), and serum alanine aminotransferase level (P < 0.005) in both genders, but it was associated with increasing visceral adipose tissue thickness (VAT; P < 0.001) and decreasing serum adiponectin levels (P < 0.05) in males alone. Males and females with NAFLD had similar amounts of SAT (P > 0.05); however, in comparison with females with NAFLD, males with NAFLD had greater VAT, a more severe metabolic phenotype with higher glucose levels and systolic blood pressure and lower adiponectin and high-density lipoprotein cholesterol levels (P < 0.001 for all), and greater measures of liver injury (alanine aminotransferase and aspartate aminotransferase, P < 0.001 for all). Similarly, metabolic syndrome was more common in males than females with NAFLD (24% versus 8%, P = 0.01). Suprailiac skinfold thickness predicted NAFLD independently of the body mass index, insulin resistance, and VAT. Conclusion: Gender differences in adolescent NAFLD are related to differences in adipose distribution and adipocytokines. The male phenotype of NAFLD is associated with more adverse metabolic features and greater visceral adiposity than the female phenotype despite the lower prevalence of NAFLD. (HEPATOLOGY 2011;)

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