Severity of liver injury and atherogenic lipid profile in children with nonalcoholic fatty liver disease.
Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. The aim of this study was to assess the relationship between severity of liver injury and atherogenic lipid profile in a large group of children with NAFLD. A total of 118 consecutive children with biopsy-proven NAFLD were included. Patients underwent extensive metabolic profiling. The NAFLD activity and fibrosis scores showed a significant positive correlation with triglyceride/HDL, total cholesterol/HDL, and LDL/HDL ratios (p<0.05) but not with apolipoprotein B/apolipoprotein A-1 ratio (p=0.58). After adjusting for BMI, homeostatic model assessment, impaired glucose tolerance, and presence of metabolic syndrome, both the NAFLD activity score and stage of fibrosis remained independent predictors of proatherogenic lipid profile. All lipid ratios, except for apolipoprotein B/apolipoprotein A-1, were found to be markedly higher in children with nonalcoholic steatohepatitis compared with those with simple steatosis or borderline disease (p<0.05). This study shows for the first time that in children with NAFLD, the severity of liver injury is strongly associated with the presence of a more atherogenic lipid profile, having potential significant diagnostic and therapeutic implications.
Nobili
Valerio
V
Liver Unit, Bambino Gesù Children's Hospital and Research Institute, Rome, Italy. nobili66@yahoo.it
Alkhouri
Naim
N
Bartuli
Andrea
A
Manco
Melania
M
Lopez
Rocio
R
Alisi
Anna
A
Feldstein
Ariel E
AE
D000293:Adolescent; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D015992:Body Mass Index; D002648:Child; D005234:Fatty Liver / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007558:Italy; D008055:Lipids / Q000097:blood*; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
D015415:Biomarkers; D008055:Lipids