Fatty liver is a good indicator of subclinical atherosclerosis risk in obese children and adolescents regardless of liver enzyme elevation
Version of Record online: 29 DEC 2012
©2012 The Author(s)/Acta Pædiatrica ©2012 Foundation Acta Pædiatrica
Volume 102, Issue 3, pages e107–e113, March 2013
How to Cite
Akın, L., Kurtoglu, S., Yikilmaz, A., Kendirci, M., Elmalı, F. and Mazicioglu, M. (2013), Fatty liver is a good indicator of subclinical atherosclerosis risk in obese children and adolescents regardless of liver enzyme elevation. Acta Paediatrica, 102: e107–e113. doi: 10.1111/apa.12099
- Issue online: 5 FEB 2013
- Version of Record online: 29 DEC 2012
- Accepted manuscript online: 28 NOV 2012 07:53PM EST
- Manuscript Accepted: 19 NOV 2012
- Manuscript Revised: 7 OCT 2012
- Manuscript Received: 23 AUG 2012
- Carotid intima media thickness;
- Children and adolescents;
- Elevated liver enzymes;
- Nonalcoholic fatty liver disease;
- Subclinical atherosclerosis
To investigate the presence of association between nonalcoholic fatty liver disease (NAFLD) and subclinical atherosclerosis using carotid intima media thickness (c-IMT) in obese children and adolescents. Additionally, we wished to investigate the relationship between fatty liver and elevated liver enzymes.
A total of 157 obese patients (78 boys and 79 girls, mean age: 11.3 ± 2.6 years, age range: 6–16 years) were enrolled in the study. Aminotransferase, fasting glucose and lipid levels were determined. An oral glucose tolerance test was performed. The c-IMT was measured. Infectious and metabolic causes of elevated liver enzymes were excluded. The diagnosis of NAFLD was based on ultrasound scan.
Obese patients with NAFLD had markedly increased carotid IMT (mean: 0.48 mm, 95% CI: 0.47–0.49) than those without NAFLD (mean: 0.45 mm 95% CI: 0.44-0.45, p < 0.001). The presence of NAFLD significantly increased c-IMT whether the patient had elevated liver enzyme or not (ANOVA, p < 0.001). In a multiple-regression model, only the presence of NAFLD was associated with increased c-IMT (β = 0.031, SE (β) = 0.008, p < 0.001).
Obese children and adolescents with NAFLD are at risk of early atherosclerotic changes. As liver function tests are not sufficient to identify patients with fatty liver, ultrasonographic evaluation of NAFLD might be considered in all obese children and adolescents.