Glucose dysregulation and hepatic steatosis in obese adolescents: is there a link?
Fatty liver is increasingly common in obese adolescents. We determined its association with glucose dysregulation in 118 (37M/81F) obese adolescents of similar age and percent total fat. Fast-magnetic resonance imaging (MRI) and simple MRI were used to quantify hepatic fat content and abdominal fat distribution. All subjects had a standard oral glucose tolerance test. Insulin sensitivity was estimated by the Matsuda Index and homeostasis model assessment of insulin resistance. Baseline total and high molecular weight (HMW)-adiponectin and interleukin (IL)-6 levels were measured. The cohort was stratified according to tertiles of hepatic fat content. Whereas age and %fat were comparable across tertiles, ethnicity differed in that fewer Blacks and more Whites and Hispanics were in the moderate and high category of hepatic fat fraction (HFF). Visceral and the visceral-to-subcutaneous fat ratio increased and insulin sensitivity decreased across tertiles. Two-hour plasma glucose rose with increasing hepatic steatosis (P < 0.008). 73.7% of the subjects in the high HFF had the metabolic syndrome compared to 19.5% and 30.6%, respectively, in the low and moderate categories. Both total and HMW-adiponectin decreased, and IL-6 increased with increasing hepatic steatosis.


CONCLUSIONS
In obese adolescents, independent of total fat, increasing severity of fatty liver is associated with glucose dysregulation, metabolic syndrome, and with a proinflammatory milieu.
Cali
Anna M G
AM
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, USA.
De Oliveira
Ana Mayra
AM
Kim
Hyeonjin
H
Chen
Shu
S
Reyes-Mugica
Miguel
M
Escalera
Sandra
S
Dziura
James
J
Taksali
Sara E
SE
Kursawe
Romy
R
Shaw
Melissa
M
Savoye
Mary
M
Pierpont
Bridget
B
Constable
R Todd
RT
Caprio
Sonia
S
D000293:Adolescent; D005234:Fatty Liver / Q000150:complications* / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000378:metabolism*
D005947:Glucose