Changes of liver fat content and transaminases in obese children after 12-mo nutritional intervention

Table 1 Body mass index -z score, fat fraction, liver echogenicity, liver biochemical parameters and lipid profile of the studied population at baseline and at the end of intervention, values are mean (SD)+ and median or number of observation (%)

Variable	Baseline (n = 46)	End of intervention (n = 46)	1P value
BMI Z score	2.3 (0.4); 2.1	1.90 (0.6); 1.9	< 0.001
Fat fraction (%)	7.8 (13.3)	0.01 (8.3)	< 0.001
FF ≥ 5%	21 (45.7)	5 (10.9)	< 0.001
FF ≥ 9%	16 (34.8)	4 (8.7)	< 0.001
Liver echogenicity (%)
0	25 (54.3)	36 (78.3)	< 0.0001
1	14 (30.4)	9 (19.6)
2	6 (13.0)	1 (2.2)
3	1 (2.2)	0 (0.0)
ALT (UI/L)	34.8 (12.0); 29.0	23.8 (8.70); 22.50	< 0.001
AST (UI/L)	30.7 (10.1); 29.0	25.9 (7.50); 26.00	< 0.001
γGT (UI/L)	15.7 (5.2); 15.0	13.1 (3.80); 12.00	< 0.001
Total cholesterol (mmol/L)	4.39 (0.70); 4.48	4.30 (0.76); 4.23	0.211
HDL cholesterol (mmol/L)	1.22 (0.24); 1.23	1.21 (0.22); 1.24	0.916
LDL cholesterol (mmol/L)	2.64 (0.59); 2.60	2.60 (0.67); 2.56	0.306
Triglycerides (mmol/L)	1.31 (0.62); 1.20	0.99 (0.46); 0.94	< 0.001
Apo A1 (g/L)	1.24 (0.21); 1.21	1.28 (0.21); 1.26	0.122
Apo B (g/L)	0.73 (0.17); 0.70	0.66 (0.15); 0.67	0.022

¹Adjusted for age, sex and duration of obesity; ²Student’s t test for paired data or Wilcoxon signed-rank test. Normal range[32]: ALT (5-45 UI/L) for age 1-19 years; AST (15-55 UI/L) for age 1-9 years and (5-45 UI/L) for age 10-19 years; gammaGT (5-32 U/I) for age 4 mo-9 years and (5-24 UI/L) for age 10-15 years. SI convertion factors: to convert cholesterol, divide values by 0.0259; to convert triglycerides, divide values by 0.0113; to convert Apo A1 and Apo B values by 0.01. BMI: Body mass index; FF: Fat fraction; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; γGT: Gamma glutamyltransferase; HDL: High-density-lipoprotein; LDL: Low-density-lipoprotein.

Table 2 Spearman correlation coefficent (P value) of fat fraction and liver echogenicity with liver function parameters

	AST	ALT	γGT
Baseline
Fat fraction	0.634 (< 0.0001)	0.456 (< 0.001)	0.469 (< 0.0001)
Liver echogenicity	0.282 (0.0530)	0.437 (< 0.001)	0.232 (0.0750)
End of treatment
Fat fraction	0.351 (0.0170)	0.297 (0.056)	0.279 (0.0630)
Liver echogenicity	0.260 (0.1030)	0.242 (0.070)	0.116 (0.2540)
Change (end of treatment-baseline)
Fat fraction	0.326 (0.0270)	0.331 (0.024)	0.271 (0.0720)
Liver echogenicity	0.225 (0.0820)	0.260 (0.063)	0.204 (0.1900)

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; γGT: Gamma glutamyltransferase.

Table 3 Liver biochemical parameters and lipid profile of the studied population at baseline and at the end of intervention in relation to liver FF, dichotomized at 9%, alues are mean (SD)+ and median

	Baseline (n = 46)		1P value	End of intervention (n = 46)		1P value
	FF < 9% (n = 30)	FF≥9% (n = 16)		FF < 9% (n = 42)	FF≥9% (n = 4)
2AST (UI/L)	26.70 (5.9); 26.00	38.20 (12.3); 40	0.001	29.10 (8.6); 28.50	34.70 (6.4); 33.00	0.015
2ALT (UI/L)	26.50 (7.7); 25.00	50.50 (28.3); 48.50	0.001	30.50 (13.6); 29.00	40.70 (16.1); 40.50	0.015
2γGT (UI/L)	14.40 (5.0); 13.00	18.20 (4.8); 17.50	0.018	15.40 (5.3); 14.50	16.00 (3.7); 15.50	0.092
Triglycerides (mmol/L)	1.14 (0.44); 1.10	1.62 (0.80); 1.38	0.013	0.96 (0.44); 0.89	1.36 (0.45); 1.25	0.090
Total cholesterol (mmol/L)	4.34 (0.69); 4.35	4.48 (0.74); 4.54	0.539	4.22 (0.73); 4.18	5.06 (0.62); 4.98	0.034
HDL cholesterol (mmol/L)	1.23 (0.21); 1.24	1.20 (0.29); 1.17	0.716	1.21 (0.20); 1.24	1.23 (0.36); 1.21	0.950
LDL cholesterol (mmol/L)	2.58 (0.61); 2.58	2.76 (0.56); 2.75	0.348	2.54 (0.63); 2.53	3.21 (0.75); 3.03	0.086
Apo A (g/L)	1.21 (0.01); 1.23	1.29 (0.24); 1.20	0.259	1.29 (0.21); 1.27	1.12 (0.13); 1.12	0.199
Apo B (g/L)	0.71 (0.18); 0.68	0.77 (0.15); 0. 70	0.261	0.65 (0.14); 0.02	0.85 (0.13); 0. 86	0.064

¹Adjusted for age, sex, BMI Z score and duration of obesity;

²Significance of difference between FF groups (Student’s t test for unpaired data or the Mann-Whitney U test). SI convertion factors: to convert cholesterol, divide values by 0.0259; to convert triglycerides, divide values by 0.0113; to convert Apo A1 and Apo B values by 0.01. Normal range[32]: ALT [5-45 UI/L] for age 1-19 years; AST [15-55 UI/L] for age 1-9 years and [5-45 UI/L] for age 10-19 years; gammaGT [5-32 U/I] for age 4 mo-9 years and [5-24 UI/L] for age 10-15 years[32]. AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; γGT: Gamma glutamyltransferase; HDL: High-density-lipoprotein; LDL: Low-density-lipoprotein.