Non-alcoholic fatty liver disease: An early mediator predicting metabolic syndrome in obese children?

doi:10.3748/wjg.v17.i6.735

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Feb 14, 2011 (publication date) through Nov 26, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Feb 14, 2011; 17(6): 735-742
Published online Feb 14, 2011. doi: 10.3748/wjg.v17.i6.735

Table 1 Characteristics of 861 obese patients

	Girls (n = 263)	Boys (n = 598)
Age (yr)	10.53 ± 2.26	10.81 ± 1.97
Tanner stage (T1/T2-4)	126/137	287/311
BMI (kg/m²)^a	27.68 ± 4.24	28.38 ± 3.47
BMI Z-score^a	4.31 ± 1.58	3.05 ± 1.16
WHR (waist/hip ratio)^a	0.93 ± 0.07	0.96 ± 0.05
Waist (cm)^a	86.53 ± 11.83	90.91 ± 10.25
Systolic pressure (mmHg)^a	114.47 ± 13.50	117.33 ± 12.55
Diastolic pressure (mmHg)	67.85 ± 9.32	68.99 ± 9.00
Cholesterol (mmol/L)	4.48 ± 1.01	4.43 ± 0.93
Triglycerides (mmol/L)	1.79 (0.19-5.17)	1.77 (0.17-10.78)
HDL	1.23 ± 0.28	1.26 ± 0.34
LDL^a	2.69 ± 0.73	2.51 ± 0.68
AI^a	2.30 ± 0.83	2.11 ± 0.74
Uric acid (μmol/L)	377.0 (203.2-705.4)	383.0 (198.2-708.5)
Fasting glucose (mmol/L)	4.87 ± 0.58	4.90 ± 0.57
120-min glucose (mmol/L)^a	6.31 ± 1.52	6.01 ± 1.44
HbA1c (%)	5.74 ± 0.57	5.69 ± 0.52
Fasting insulin (mIU/L)^a	17.9 (0.3-303.0)	15.3 (0.3-219.0)
HOMA-IR^a	3.77 (0.07-78.11)	3.33 (0.07-51.59)
WBISI^a	2.59 (0.39-11.90)	3.37 (0.52-24.19)
ALT (U/L)^a	37.5 (8.0-283.0)	29.0 (4.0-561.0)

^aP < 0.05 boys vs girls. Data are expressed as mean ± SD or median (range). BMI: Body mass index; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; AI: Atherogenic index; HOMA-IR: Homeostasis model assessment of insulin resistance; WBISI: Whole-body insulin sensitivity index; ALT: Alanine aminotransferase.

Table 2 Comparison of prevalence of metabolic syndrome and its components among three groups

	Group 0 (n = 274)	NAFLD
	Group 0 (n = 274)	Group 1 (n = 436)	Group 2 (n = 151)
Age (yr)	10.36 ± 2.15	10.59 ± 1.85	10.40 ± 2.28
Sex (M/F)	187/87	305/131	106/45
Tanner stage (T1/T2–4)	130/144	209/227	74/77
BMI	26.88 ± 3.19	28.78 ± 3.96^a	28.85 ± 3.69^a
Hypertension	68 (24.82)	180 (41.28)^a	73 (48.34)^a
Dyslipidemia	42 (15.32)	204 (46.78)^a	116 (76.82)^a^c
Impaired fasting glucose	5 (1.82)	30 (6.88)	20 (13.24)^a^c
IGT	13 (4.74)	38 (8.72)	18 (11.92)^a
Diabetes	0 (0.00)	5 (1.14)	7 (4.63)^a^c
MS	33 (12.04)	128 (29.36)^a	60 (39.74)^a^c

^aP < 0.05 vs group 0;

^cP < 0.05, group 1 vs group 2. Data are expressed as percentage, mean ± SD. NAFLD: Non-alcoholic fatty liver disease; BMI: Body mass index; IGT: Impaired glucose tolerance; MS: Metabolic syndrome.

Table 3 Clinical and laboratory data of non-alcoholic fatty liver disease compared with obese children without liver disorder

	Group 0 (n = 274)	NAFLD
		Group 1 (n = 436)	Group 2 (n = 151)
Age (yr)	10.36 ± 2.15	10.59 ± 1.85	10.40 ± 2.28
BMI (kg/m²)	26.58 ± 3.19	28.85 ± 3.69^a	28.78 ± 3.96^a
BMI Z-score	3.17 ± 1.26	3.33 ± 1.37	3.93 ± 1.60^a^c
Waist circumference (cm)	85.63 ± 10.17	91.58 ± 11.24^a	92.2 ± 9.31^a
Father BMI (kg/m²)	25.12 ± 3.68	25.68 ± 5.78	25.55 ± 3.75
Mother BMI (kg/m²)	22.83 ± 3.14	23.46 ± 3.61^a	23.64 ± 3.38^a
Systolic blood pressure (mmHg)	113.62 ± 11.89	118.30 ± 13.37^a	118.03 ± 12.73^a
Diastolic blood pressure (mmHg)	67.80 ± 9.02	69.00 ± 9.38	69.43 ± 8.67^a
ALT (U/L)	24 (8-74)	29 (4-75)^a	51.5 (76-561)^a^c
Uric acid (μmol/L)	352.9 (186.5-603.20)	365.9 (168.10-708.50)^a	412.5 (7.38-771.30)^a^c
Triglycerides (mmol/L)	1.4 (0.19-6.76)	1.42 (0.26-5.90)	1.77 (0.28-8.64)^a^c
Cholesterol (mmol/L)	4.37 ± 0.99	4.34 ± 0.87	4.71 ± 0.99^a^c
HDL	1.29 ± 0.39	1.23 ± 0.28	1.22 ± 0.28
LDL	2.52 ± 0.66	2.54 ± 0.68	2.68 ± 0.78
AI	2.07 ± 0.73	2.15 ± 0.70	2.31 ± 0.92^a
Fasting blood glucose (mmol/L)	4.82 ± 0.52	4.88 ± 0.69	4.95 ± 0.55^a
30-min OGTT glucose (mmol/L)	7.54 ± 1.17	7.73 ± 1.24	7.69 ± 1.21
120-min OGTT glucose (mmol/L)	5.66 ± 1.36	6.31 ± 1.42^a	6.22 ± 1.63^a
HbA1c (%)	5.70 ± 0.50	5.71 ± 0.53	5.65 ± 0.62
Fasting insulin (mIU/L)	12.7 (0.3-187.0)	17.0 (0.3-219.0)^a	18.2 (2.1-303.0)^a
30-min OGTT insulin (mIU/L)	85.3 (1.8-400.0)	112.0 (0.5-400.0)^a	106.2 (1.6-400.0)^a
120-min OGTT insulin (mIU/L)	36.3 (3.2-400.0)	63.6 (1.7-386.0)^a	69.8 (7.0-400.0)^a
HOMA-IR	2.61 (0.07-41.56)	3.71 (0.08-51.59)^a	3.95 (0.48-78.11)^a
WBISI	4.0 (0.6-16.4)	2.8 (0.9-24.2)^a	2.6 (0.4-16.7)^a

^aP < 0.05 vs group 0;

^cP < 0.05, group 1 vs group 2. Data are expressed as mean ± SD or median (range). NAFLD: Non-alcoholic fatty liver disease; BMI: Body mass index; ALT: Alanine aminotransferase; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; AI: Atherogenic index; OGTT: Oral glucose tolerance test; HOMA-IR: Homeostasis model assessment of insulin resistance; WBISI: Whole-body insulin sensitivity index.

Table 4 Metabolic syndrome in obese patients diagnosed by B-ultrasound

	Scale (0) (n = 274)	Scale (1) (n = 105)	Scale (2-3) (n = 482)	P
Hypertension
No	206	54	280
Yes	68	51	202	< 0.05
OR (95% CI)	1.0	2.87 (1.29-6.37)	2.18 (1.27-3.75)
Dyslipidemia
No	232	57	210
Yes	42	48	272	< 0.01
OR (95% CI)	1.0	5.21 (2.23-12.18)	7.99 (4.34-14.73)
Impaired fasting glucose
No	269	102	435
Yes	5	3	47	< 0.05
OR (95% CI)	1.0	1.0 (0.1-9.94)	3.65 (1.04-12.85)
Impaired glucose tolerance
No	261	99	432
Yes	13	6	50	> 0.05
OR (95% CI)	1.0	1.53 (0.27-8.74)	2.9 (0.95-8.87)
Hyperuricacidemia
No	232	81	301
Yes	42	24	181	< 0.01
OR (95% CI)	1.0	1.83 (0.71-4.74)	3.76 (2.03-6.96)
MS
No	241	75	324
Yes	33	30	158	< 0.01
OR (95% CI)	1.0	3.10 (1.20-8.00)	3.77 (1.90-7.47)

MS: Metabolic syndrome; OR: Odds ratio; CI: Confidence interval.

Citation: Fu JF, Shi HB, Liu LR, Jiang P, Liang L, Wang CL, Liu XY. Non-alcoholic fatty liver disease: An early mediator predicting metabolic syndrome in obese children? World J Gastroenterol 2011; 17(6): 735-742
URL: https://www.wjgnet.com/1007-9327/full/v17/i6/735.htm
DOI: https://dx.doi.org/10.3748/wjg.v17.i6.735