title: Factors associated with insulin resistance and non-alcoholic fatty liver disease among youths.
abstract: OBJECTIVE
  To compare the cardio-metabolic risk factors, fitness and lifestyle among adolescents with and without weight disorders and/or metabolic abnormality, and to identify the factors associated with insulin resistance and non-alcoholic fatty liver disease (NAFLD) in this age group.
  
  
  METHODS
  This cross-sectional study comprised 100 adolescents (12-18 years) consisting of four subgroups of normal weight/obese with and without components of the metabolic syndrome. Fasting blood glucose, insulin, lipid profile, apolipoproteins A, B, CRP, oxidized-LDL, malondialdehyde and alanine aminotransferase (ALT) were examined. Cardiorespiratory fitness (CRF) and the sonographic findings of liver and carotid intima media thickness were determined.
  
  
  RESULTS
  Overall 95 participants completed all tests. Serum lipids, lipoproteins, the markers of inflammation and oxidative stress as well as the C-IMT of normal weight children with a metabolic abnormality were similar to obese children. CRF had the highest inverse correlation with HOMA-IR and ALT. Physical activity and healthy eating index had similar inverse correlation with HOMA-IR and ALT. ApoB/ApoA-I had significant independent association with upper quartiles of HOMA-IR and ALT. Waist circumference and ApoB/ApoA-I ratio had the highest odds ratio in increasing the risk of insulin resistance and NAFLD, whereas CRF followed by healthy eating index decreased this risk significantly. C-IMT was significantly associated with insulin resistance and NAFLD.
  
  
  CONCLUSIONS
  We found significant associations between insulin resistance and NAFLD, and similar risk factors and protective factors for these two inter-related disorders; in this regard the role of CRF and apolipoprotein B to apolipoprotein A-I (ApoB/ApoA-I) ratio in the pediatric age group is underscored.
authors.affiliation: Pediatric Preventive Cardiology Department, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, P.O. Box 81465-1148, Isfahan, Iran. kroya@aap.net
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Cook
authors.forename: Babak
authors.initials: B
authors.lastname: Amra
authors.forename: Atoosa
authors.initials: A
authors.lastname: Adibi
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D016632:Apolipoprotein A-I / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet / Q000009:adverse effects; D015444:Exercise; D005234:Fatty Liver / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008019:Life Style; D008077:Lipoproteins, LDL / Q000097:blood; D016015:Logistic Models; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D014463:Ultrasonography; D055105:Waist Circumference
chemical_list: C505693:APOA1 protein, human; D016632:Apolipoprotein A-I; D001055:Apolipoproteins B; D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein; D008315:Malondialdehyde; D000410:Alanine Transaminase