title: Biochemical, anthropometric and body composition indicators as predictors of hepatic steatosis in obese adolescents.
abstract: OBJECTIVE
  To describe the prevalence of hepatic steatosis and to assess the performance of biochemical, anthropometric and body composition indicators for hepatic steatosis in obese teenagers.
  
  
  METHODS
  Cross-sectional study including 79 adolecents aged from ten to 18 years old. Hepatic steatosis was diagnosed by abdominal ultrasound in case of moderate or intense hepatorenal contrast and/or a difference in the histogram ≥7 on the right kidney cortex. The insulin resistance was determined by the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index for values >3.16. Anthropometric and body composition indicators consisted of body mass index, body fat percentage, abdominal circumference and subcutaneous fat. Fasting glycemia and insulin, lipid profile and hepatic enzymes, such as aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase and alkaline phosphatase, were also evaluated. In order to assess the performance of these indicators in the diagnosis of hepatic steatosis in teenagers, a ROC curve analysis was applied.
  
  
  RESULTS
  Hepatic steatosis was found in 20% of the patients and insulin resistance, in 29%. Gamma-glutamyltransferase and HOMA-IR were good indicators for predicting hepatic steatosis, with a cutoff of 1.06 times above the reference value for gamma-glutamyltransferase and 3.28 times for the HOMA-IR. The anthropometric indicators, the body fat percentage, the lipid profile, the glycemia and the aspartate aminotransferase did not present significant associations.
  
  
  CONCLUSIONS
  Patients with high gamma-glutamyltransferase level and/or HOMA-IR should be submitted to abdominal ultrasound examination due to the increased chance of having hepatic steatosis.
authors.affiliation: Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Amanda Oliva
authors.initials: AO
authors.lastname: Gobato
authors.affiliation: Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Ana Carolina J
authors.initials: AC
authors.lastname: Vasques
authors.affiliation: Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Roberto Massao
authors.initials: RM
authors.lastname: Yamada
authors.affiliation: Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Mariana Porto
authors.initials: MP
authors.lastname: Zambon
authors.affiliation: Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Antonio de Azevedo
authors.initials: Ade A
authors.lastname: Barros-Filho
authors.affiliation: Faculdade de Ciências Médicas, Unicamp, Campinas, SP, Brasil.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Hessel
mesh_terms: D000293:Adolescent; D001823:Body Composition; D001837:Body Weights and Measures; D002648:Child; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000150:complications; D015995:Prevalence