Cord blood adipokines and lipids and adolescent non-alcoholic fatty liver disease

CONTEXT: Maternal adiposity in pregnancy is associated with offspring adiposity and metabolic dysfunction postnatally, including greater risk of non-alcoholic fatty liver disease (NAFLD). Recent genetic analyses suggest a causal effect of greater maternal body mass index on offspring birthweight and ponderal index but the relative roles of the environment in-utero or later in life remains unclear.

OBJECTIVE: We sought to determine whether markers of infant adiposity (birthweight, umbilical cord blood leptin, adiponectin and lipids) were associated with markers of NAFLD in adolescence.

DESIGN, SETTING AND PARTICIPANTS: UK prospective birth cohort with 17 years of follow-up with liver function tests (AST, ALT, GGT) (n=1037 participants), and ultrasound scan assessed liver fat, volume and sheer velocity at age 17 (n=541 participants). Missing covariate data were imputed.

MAIN OUTCOMES: Ultrasound and biochemical measures of NAFLD Results: Birthweight, cord blood leptin and adiponectin were not associated with a diagnosis of NAFLD. In adjusted analyses two out of 42 associations attained conventional 5% levels of significance. Birthweight was positively associated with liver volume (1.0% greater per 100g (95% CI: 0.5, 2.0%)). Cord HDL-c was positively associated with ALT (11.6% higher per 1mmol/l (95% CI 0.3, 23.4)), however, this association was primarily mediated via offspring adiposity.

CONCLUSIONS: In this extensive analysis we found little evidence measurements of infant fat mass and birth size were related to adolescent markers of NAFLD. The association between birthweight and adolescent liver volume may indicate the contribution of greater organ size to birthweight and tracking of organ size.