title: Association between nonalcoholic fatty liver disease and cardiovascular risk in obese children and adolescents.
abstract: BACKGROUND
  The recent rise in the prevalence of obesity likely explains nonalcoholic fatty liver disease (NAFLD) epidemic worldwide. We evaluated cardiac functions, cardiovascular risk, and associated parameters with grades of NAFLD in obese children.
  
  
  METHODS
  Four hundred obese children were enrolled in the study. Obese children with NAFLD were classified in 2 subgroups according to ultrasonographic visualizing. Ninety-three obese children with NAFLD (mean age 11.73 ± 2.72 years in group 2 and 12.69 ± 2.61 years in group 3) were compared with 307 age- and sex-matched non-NAFLD obese children and 150 control subjects. Laboratory parameters were measured during the fasting state. Pulsed and tissue Doppler echocardiography were performed. Intima-media (IMT) and epicardial adipose tissue (EAT) thicknesses were measured.
  
  
  RESULTS
  NAFLD groups had a significantly higher body mass index (29.15 ± 3.42 and 30.46 ± 4.60; P < 0.001), total adipose tissue mass (37.95 ± 4.46% and 46.57 ± 6.45%; P < 0.001), higher insulin, alanine aminotransferase, and aspartate aminotransferase levels. Increased end-systolic thickness of the interventricular septum (P < 0.001), larger left ventricular mass (P < 0.003) and index (P < 0.003) were found in NAFLD groups. Children with NAFLD had higher Tei index values. Also, carotid artery IMT and EAT thickness were significantly higher in obese children. Waist and hip circumference, total cholesterol level, total adipose tissue mass, and interventricular septum were statistically different in NAFLD groups.
  
  
  CONCLUSIONS
  Children with NAFLD had mildly altered left and right ventricular functions and all obese children had increased IMT and EAT thickness. Also, grade of liver steatosis was positively correlated with total adipose tissue mass and interventricular septum systolic thickness.
authors.affiliation: Department of Pediatric Cardiology, Necmettin Erbakan University, Meram School of Medicine Hospital, Konya, Turkey. drhayrullahalp@hotmail.com
authors.forename: Hayrullah
authors.initials: H
authors.lastname: Alp
authors.forename: Sevim
authors.initials: S
authors.lastname: Karaarslan
authors.forename: Beray
authors.initials: B
authors.lastname: Selver Eklioğlu
authors.forename: Mehmet Emre
authors.initials: ME
authors.lastname: Atabek
authors.forename: Hakan
authors.initials: H
authors.lastname: Altın
authors.forename: Tamer
authors.initials: T
authors.lastname: Baysal
mesh_terms: D000273:Adipose Tissue / Q000473:pathology; D000293:Adolescent; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D015150:Echocardiography, Doppler / Q000379:methods; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors