Nonalcoholic fatty liver disease and carotid atherosclerosis in children.
Nonalcoholic fatty liver disease (NAFLD) is closely associated with several metabolic syndrome features, including obesity, dyslipidemia, insulin resistance, and increased cardiovascular risk. The present study was undertaken to assess whether NAFLD in children is associated with increased carotid artery intima-media thickness (IMT), a marker of early-generalized atherosclerosis. We analyzed carotid IMT along with serum triglycerides, total, low-density lipoprotein and high-density lipoprotein cholesterol, glucose, insulin, insulin resistance index (as homeostasis model assessment of insulin resistance), aminotransferases, leptin, and adiponectin in 29 obese children with NAFLD, 33 obese children without liver involvement, and 30 control children. The diagnosis and severity of NAFLD was based on ultrasound scan, after exclusion of infectious and metabolic disorders. Obese children with NAFLD had significantly increased carotid IMT [mean 0.58 (95% confidence intervals 0.54-0.62 mm)] than obese children without liver involvement [0.49 (0.46-0.52) mm; p = 0.001] and control children [0.40 (0.36-0.43) mm; p < 0.0005]. In a stepwise multiple regression model, after adjusting for age, gender, Tanner stage, and cardiovascular risk factors, the severity of fatty liver was significantly associated with maximum IMT (b = 0.08; p < 0.0005). Our results suggest that NAFLD is strongly associated with carotid atherosclerosis even in childhood.
Pacifico
Lucia
L
Department of Pediatrics, La Sapienza University of Rome, 00161 Rome, Italy. lucia.pacifico@uniroma1.it
Cantisani
Vito
V
Ricci
Paolo
P
Osborn
John F
JF
Schiavo
Elisa
E
Anania
Caterina
C
Ferrara
Eva
E
Dvisic
Giuliano
G
Chiesa
Claudio
C
D001786:Blood Glucose / Q000378:metabolism; D002340:Carotid Artery Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000097:blood / Q000150:complications*; D012307:Risk Factors; D012720:Severity of Illness Index; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides