Nonalcoholic Fatty Liver Disease, Liver Fibrosis, and Cardiometabolic Risk Factors in Adolescence: A Cross-Sectional Study of 1874 General Population Adolescents

Debbie A. Lawlor*, Mark Callaway, Corrie Macdonald-Wallis, Emma L Anderson, Abigail Fraser, Laura D. Howe, Chris Day, Naveed Sattar

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)

33 Citations (Scopus)

Abstract

Context: The impact of adolescent nonalcoholic fatty liver disease (NAFLD) on health, independent of fat mass, is unclear.

Objective: The objective of the study was to determine the independent (of total body fat) association of ultrasound scan (USS)-determined NAFLD with liver fibrosis, insulin resistance, and dyslipidemia among healthy adolescents.

Design: This was a cross-sectional analysis in participants from a UK birth cohort.

Participants: One thousand eight hundred seventy-four (1059 female) individuals of a mean age of 17.9 years participated in the study.

Main Outcomes: USS assessed liver stiffness (shear velocity, an indicator of fibrosis) and volume, fasting glucose, insulin, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, alanine amino transferase, aspartate amino transferase, gamma-glutamyltransferase, and haptoglobin.

Results: The prevalence of NAFLD was 2.5% [95% confidence interval (CI) 1.8-3.3] and was the same in females and males. Dual-energy X-ray absorptiometry determined total body fat mass was strongly associated with USS NAFLD: odds ratio 3.15 (95% CI 2.44-4.07) per 1 SD (similar to 10 kg) fat mass. Those with NAFLD had larger liver volumes and greater shear velocity. They also had higher fasting glucose, insulin, triglycerides, low-density lipoprotein cholesterol, alanine amino transferase, aspartate amino transferase, gamma-glutamyltransferase, and haptoglobin and lower high-density lipoprotein cholesterol. Most associations were independent of total body fat. For example, after adjustment for fat mass and other confounders, hepatic shear velocity [mean difference 22.8% (95% CI 15.6-30.5)], triglyceride levels [23.6% (95% CI 6.0-44.2)], and insulin [39.4% (95% CI 10.7-75.5)] were greater in those with NAFLD compared with those without NAFLD.

Conclusion: In healthy European adolescents, 2.5% have USS-defined NAFLD. Even after accounting for total body fat, those with NAFLD have more adverse levels of liver fibrosis and cardiometabolic risk factors.

Original languageEnglish
Pages (from-to)E410-E417
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume99
Issue number3
DOIs
Publication statusPublished - Mar 2014

Keywords

  • Adolescent
  • Body Composition
  • Cardiovascular Diseases
  • Cross-Sectional Studies
  • Fatty Liver
  • Female
  • Great Britain
  • Humans
  • Liver Cirrhosis
  • Male
  • Metabolic Syndrome X
  • Non-alcoholic Fatty Liver Disease
  • Risk Factors

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