title: Factors associated with hepatic steatosis in obese children and adolescents.
abstract: OBJECTIVE
  Obesity is associated with high prevalence of hepatic steatosis. We speculate that determinant factors of susceptibility to hepatic steatosis in obesity could differ between children and adolescents.
  
  
  METHODS
  Blood biochemical parameters, systemic oxidative stress markers, proinflammatory cytokines, and adipokine levels were determined in 157 obese children and adolescents. The subjects were divided into 2 groups: children and adolescents, identified as such in accordance with Tanner stage and the measured level of dehydroepiandrosterone sulphate. Steatosis was evaluated by ultrasonography in 127 subjects.
  
  
  RESULTS
  Steatosis prevalence was 44.8%. In the "children" group, those with hepatic steatosis presented higher levels of erythrocyte oxidised glutathione (GSSG) and resistin, lower levels of high-density lipoprotein (HDL) cholesterol, and lower enzymatic activities of erythrocyte glutathione reductase (GRd) and glutathione oxidase (GPx). In the "adolescents" group, those with hepatic steatosis presented higher values for body mass index z score (BMIz), insulin, peptide C, homeostatic model assessment index (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycerides, GSSG, and leptin. These subjects also presented lower values for soluble leptin receptor, GRd, and GPx. In the "children" group, the only independent factor of steatosis was a decrease in GRd activity (odds ratio [OR] 0.165, 95% CI 0.03-0.84, P = 0.030). Moreover, in the "adolescent" group, the independent factors were higher for GSSG (OR 6.8, 95% CI 1.6-28.7, P = 0.010) and HOMA-IR (OR 1.9, 95% CI 1.17-3.1, P = 0.009).
  
  
  CONCLUSIONS
  Factors associated with hepatic steatosis differ between obese children and adolescents. Oxidative stress is seen to be the main process in children, whereas in adolescents oxidative stress and insulin resistance are significant factors for steatosis.
authors.affiliation: Paedriatric Unit, San Cecilio University Hospital, Granada, Spain.
authors.forename: Ángeles
authors.initials: Á
authors.lastname: Ruiz-Extremera
authors.forename: Ángel
authors.initials: Á
authors.lastname: Carazo
authors.forename: Ángela
authors.initials: Á
authors.lastname: Salmerón
authors.forename: Josefa
authors.initials: J
authors.lastname: León
authors.forename: Jorge
authors.initials: J
authors.lastname: Casado
authors.forename: Alejandro
authors.initials: A
authors.lastname: Goicoechea
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Fernandez
authors.forename: Maximiliano
authors.initials: M
authors.lastname: Garofano
authors.forename: Esther
authors.initials: E
authors.lastname: Ocete
authors.forename: Ana Belén
authors.initials: AB
authors.lastname: Martín
authors.forename: Esther
authors.initials: E
authors.lastname: Pavón
authors.forename: Javier
authors.initials: J
authors.lastname: Salmerón
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D015992:Body Mass Index; D002648:Child; D002657:Child Development; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D006785:Hospitals, University; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D009765:Obesity / Q000097:blood / Q000503:physiopathology*; D018384:Oxidative Stress; D015995:Prevalence; D052243:Resistin / Q000097:blood; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014463:Ultrasonography
chemical_list: C499624:RETN protein, human; D052243:Resistin