title: Insulin resistance, body composition, and fat distribution in obese children with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  The aim of this study was to evaluate the influence of body composition, especially distribution of body fat, and insulin resistance on nonalcoholic fatty liver disease (NAFLD) in obese children.
  
  
  METHODS
  One hundred obese children (66 boys, 34 girls) with (n=60) and without NAFLD (n=40) were assessed. Anthropometry, laboratory tests, abdominal ultrasonography, and dual energy x-ray absorption metry (DXA) were evaluated in all subjects.
  
  
  RESULTS
  Subject age and measurements of liver enzymes, γ- glutamyl transpeptidase (γGT), uric acid, high-density lipoprotein cholesterol, and insulin resistance were significantly different between the non-NAFLD group and NAFLD group. Body fat and trunk fat percentage were significantly different between the two groups (p<0.001 and p=0.003), whereas extremity fat percentage was not (p=0.683). Insulin resistance correlated significantly with body fat and trunk fat percentages, age, liver enzymes, γGT, and uric acid in obese children. Multiple logistic regression analysis indicated that insulin resistance and trunk fat percentage significantly affected the development of NAFLD in obese children.
  
  
  CONCLUSIONS
  Body fat, especially abdominal fat, influences the development of insulin resistance and subsequent NAFLD in obese children. Therefore, body composition measurement using DXA, in conjunction with biochemical tests, may be beneficial in evaluating obese children with NAFLD.
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea. Email: hryang@snubh.org.|Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hye Ran
authors.initials: HR
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Eun Jae
authors.initials: EJ
authors.lastname: Chang
mesh_terms: D050153:Abdominal Fat / Q000503:physiopathology; D015502:Absorptiometry, Photon; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008099:Liver / Q000201:enzymology; D016015:Logistic Models; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000209:etiology / Q000503:physiopathology*; D009765:Obesity / Q000150:complications* / Q000503:physiopathology*; D014527:Uric Acid / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D008055:Lipids; D014527:Uric Acid; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase