Amount of hepatic fat predicts cardiovascular risk independent of insulin resistance among Hispanic-American adolescents.
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) has emerged as the major pediatric chronic liver disease, and it is estimated to affect more than one third of obese children in the U.S. Cardiovascular complications are a leading cause of increased mortality in adults with NAFLD and many adolescents with NAFLD already manifest signs of subclinical atherosclerosis including increased carotid intima-media thickness.


METHODS
Volume of intrahepatic fat was assessed in 50 Hispanic-American, overweight adolescents, using Magnetic Resonance Spectroscopy. Lipoprotein compositions were measured using Nuclear Magnetic Resonance.


RESULTS
Plasma triglycerides (TG) (p=0.003), TG/HDL ratio (p=0.006), TG/apoB ratio (p=0.011), large VLDL concentration (p=0.019), VLDL particle size (p=0.012), as well as small dense LDL concentration (p=0.026) progressively increased across higher levels of hepatic fat severity, while large HDL concentration progressively declined (p=0.043). This pattern of associations remained even after controlling for gender, BMI, visceral fat, and insulin resistance.


CONCLUSIONS
Our findings suggest that increased hepatic fat is strongly associated with peripheral dyslipidemia and the amount of fat in the liver may influence cardiovascular risk. Further studies are needed to longitudinally monitor dyslipidemia in children with NAFLD and to examine whether the reduction of hepatic fat would attenuate their long-term CVD risk.
Division of Pediatric Gastroenterology, Hepatology and Nutrition, School of Medicine, Emory University, Atlanta, GA, 30322, USA. rjin@emory.edu.
Ran
R
Jin
Biomarker Core Laboratory, Atlanta Veterans Affairs Medical Center, Decatur, GA, USA. Anh.Le@va.gov.
Ngoc-Anh
NA
Le
Division of Pediatric Gastroenterology, Hepatology and Nutrition, School of Medicine, Emory University, Atlanta, GA, 30322, USA. Rebecca.Cleeton@choa.org.
Rebecca
R
Cleeton
Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA. xsun33@emory.edu.
Xiaoyan
X
Sun
Division of Pediatric Gastroenterology, Hepatology and Nutrition, School of Medicine, Emory University, Atlanta, GA, 30322, USA. jessica.cruz.munos@emory.edu.
Jessica
J
Cruz Muños
LipoScience Inc, Raleigh, NC, USA. jotvos@liposcience.com.
James
J
Otvos
Division of Pediatric Gastroenterology, Hepatology and Nutrition, School of Medicine, Emory University, Atlanta, GA, 30322, USA. mvos@emory.edu.|Children's Healthcare of Atlanta, Atlanta, GA, USA. mvos@emory.edu.
Miriam B
MB
Vos
D000293:Adolescent; D001055:Apolipoproteins B / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015243:Cholesterol, VLDL / Q000097:blood; D003430:Cross-Sectional Studies; D005223:Fats / Q000032:analysis*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000737:chemistry*; D008279:Magnetic Resonance Imaging; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications; D014280:Triglycerides / Q000097:blood
D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D005223:Fats; D014280:Triglycerides