title: Investigating a Liver Fat: Arterial Stiffening Pathway in Adult and Childhood Obesity.
abstract: OBJECTIVE
  To investigate the relationship between hepatic fat content, circulating triglyceride levels and aortic stiffness in adult and childhood obesity.
  
  
  RESULTS
  Seventy-seven adults and 18 children across a wide range of body mass index (18.5-52.6 kg/m(2); percentile 8-100) with no identifiable cardiac risk factors underwent; 1H- magnetic resonance spectroscopy to quantify hepatic fat content and magnetic resonance imaging to assess aortic pulse wave velocity (PWV) and regional distensibility. In adults, multivariable regression showed age (β=0.09; P=0.02), liver fat (β=2.5; P=0.04), and serum triglyceride (β=0.47; P=0.01) to be independent predictors of PWV. Age and blood pressure-adjusted, moderated regression showed that 43% of the total negative effect of hepatic fat on PWV is attributable to indirect effects via increased triglyceride (P=0.005). In addition, regional distensibility was positively correlated with hepatic fat (ascending; r=-0.35; descending, r=-0.23; abdominal, r=-0.41; all P<0.001). Similar to that seen in adults, PWV (r=0.72; P<0.001) and abdominal regional distensibility (r=-0.52; P<0.001) were correlated with liver fat in children.
  
  
  CONCLUSIONS
  Increasing age, liver fat, and triglyceride are all related to increased aortic stiffness in adults. Even when controlling for the effects of age and blood pressure, hepatic fat has a negative effect on PWV, with substantial indirect effect occurring via increased circulating triglyceride level. This relationship between hepatic fat and aortic stiffness occurs early in the obesity process and is also seen in children. As such, hepatic fat content is a potential therapeutic target to treat the elevated vascular risk in obesity.
authors.affiliation: From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.). oliver.rider@gmail.com.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Rider
authors.affiliation: From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.).
authors.forename: Rajarshi
authors.initials: R
authors.lastname: Banerjee
authors.affiliation: From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.).
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Rayner
authors.affiliation: From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.).
authors.forename: Ravi
authors.initials: R
authors.lastname: Shah
authors.affiliation: From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.).
authors.forename: Venkatesh L
authors.initials: VL
authors.lastname: Murthy
authors.affiliation: From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.).
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Robson
authors.affiliation: From the Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (O.J.R., R.B., J.J.R., M.D.R., S.N.); Beth Israel Deaconess Medical Center, Boston, MA (R.S.); and Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor (V.L.M.).
authors.forename: Stefan
authors.initials: S
authors.lastname: Neubauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D002648:Child; D003430:Cross-Sectional Studies; D006801:Humans; D016014:Linear Models; D008099:Liver / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D063766:Pediatric Obesity / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D011237:Predictive Value of Tests; D066244:Proton Magnetic Resonance Spectroscopy; D063177:Pulse Wave Analysis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D059289:Vascular Stiffness; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014280:Triglycerides
keywords: liver; magnetic resonance imaging; obesity; pulse wave analysis; triglycerides