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).
Steatohepatitis/Metabolic Liver Disease
Article first published online: 2 MAR 2011
Copyright © 2010 American Association for the Study of Liver Diseases
Volume 53, Issue 3, pages 800–809, March 2011
How to Cite
Ayonrinde, O. T., Olynyk, J. K., Beilin, L. J., Mori, T. A., Pennell, C. E., de Klerk, N., Oddy, W. H., Shipman, P. and Adams, L. A. (2011), Gender-specific differences in adipose distribution and adipocytokines influence adolescent nonalcoholic fatty liver disease . Hepatology, 53: 800–809. doi: 10.1002/hep.24097
Potential conflict of interest: Nothing to report.
- Issue published online: 2 MAR 2011
- Article first published online: 2 MAR 2011
- Accepted manuscript online: 6 DEC 2010 12:52PM EST
- Manuscript Accepted: 22 NOV 2010
- Manuscript Received: 1 SEP 2010
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;)