ESPE Abstracts (2016) 86 P-P1-479

Hepatic Steatosis and Cardiovascular Risk in Overweight Children: Preliminary Results of the Study EFIGRO

Ignacio Diez-Lopeza,b, Ainhoa Sarasuaa, Maria Medranob,c, Lyde Arenazad,e, Beatriz Rodriguez-Vigilf, Ignacio Tobalinag, Eider Larrarteh, Javier Perez-Asenjoi & Idoia Labayenb,e


aUnidad de Endocrinología Pediátrica, Hospital Universitario de Álava, Vitoria-Gasteiz, Vitoria Basque Country, Spain; bBasque Country University, Vitoria Basque Country, Spain; cNutrition, Exercise and Health Research Group, Elikadura, Ariketa Fisikoa eta Osasuna, ELIKOS Group, Universidad del País Vasco, UPV/EHU, Vitoria-Gasteiz, Vitoria Basque Country, Spain; dDepartmento de Educación y Física y del Deporte, Universidad del País Vasco, UPV/EHU, Vitoria-Gasteiz, Vitoria Basque Country, Spain; eDepartmento de Nutrición y Bromatología, Universidad del País Vasco, UPV/EHU, Vitoria-Gasteiz, Vitoria Basque Country, Spain; fServicio de Resonancia Magnética, Osatek, Hospital Universitario de Álava, Vitoria-Gasteiz, Vitoria Basque Country, Spain; gServicio de Medicina Nuclear, Hospital Universitario de Álava, Vitoria-Gasteiz, Vitoria Basque Country, Spain; hUnidad de Salud y Calidad de Vida, Tecnalia, Vitoria-Gasteiz, Vitoria Basque Country, Spain; iServicio de Cardiología, Igualatorio Médico Quirúrgico (IMQ), Vitoria-Gasteiz, Vitoria Basque Country, Spain


Introduction: The accumulation of fat in the liver is a serious complication of childhood obesity seems to be associated with cardiometabolic risk.

Objective: To examine the association between fat accumulation in the liver and cardiovascular risk factors in overweight children.

Material and methods: In the study 68 children/as (51.4% girls) were overweight or obese (defined according to the classification criteria of the International Federation of Obesity, IOTF) between 9 and 11 years they participated Vitoria-Gasteiz. liver fat (nuclear magnetic resonance), total and abdominal fat (dual absorptiometry X-rays), blood pressure and blood levels of fasting glucose, insulin, total cholesterol, HDL and LDL, triglycerides were measured, alanine transaminase (ALT), GGT (gamma-GT), aspartate transaminase (AST) and uric acid.

Results: A total of 16 children/as (23.5%) had hepatic steatosis (>4.85% fat in the liver). No significant differences in body mass index, the percentage of obesity, and glucose levels, total cholesterol, HDL and LDL among children with and without hepatic steatosis were found. However, the percentage of total abdominal fat (P<0.05), systolic blood pressure (P=0.042) and diastolic (P=0.003) insulin concentrations (P<0.05), triglycerides (P=0.024), uric acid (P=0.030), ALT (P=0.024) and gamma-GT (P<0.001) were significantly higher and the rate of AST/lower ALT (P<0.001) in children/as with hepatic steatosis. The percentage of fat liver showed significant associations with total fat (β=0.24, P=0.048) and abdominal (β=0.26; P=0.025) and plasma insulin levels (β=0.24; P=0.041) regardless of age and sex.

Table 1. Differences in body composition and cardiovascular risk factors in children aged 9–11 years overweight (>4.85% hepatic fat) without non-alcoholic fatty liver disease
Control (N=52)Hepatic Steatosis (n=16)P
Age (years)10.4 (1.0)10.4 (0.9)0.822
Girls (N, %)28, 53.87, 43.80.480
BMI (kg/m2)25.3 (3.2)26.7 (4.1)0.252
Overweight/obesity/obesity II21, 27, 43, 10, 20.329
Fat mass (%)39.7 (4.8)42.5 (4.6)0.046
Level of fat mass (kg/m2)10.1 (2.3)11.3 (2.9)0.089
Free of fat mass (kg)30.5 (5.1)32.2 (5.1)0.270
Abdominal fat R1 (g)1569 (607)2087 (859)0.036
Abdominal fat R2 (g)2041 (793)2653 (1030)0.041
Abdominal fat R3 (g)2545 (1038)4422 (5026)0.014
Hepatic fat (%)2.9 (1.0)10.4 (6.7)<0.001
Systolic P (mm Hg)96.5 (12.1)103.1 (2.8)0.042
Dyastolic P (mm Hg)62.7 (5.8)68.6 (9.0)0.003
Glucose (mg/dl)86 (5)86 (6)0.749
Insulin (μU/ml)11 (3)15 (5)0.033
A.uric (mg/dl)4.5 (0.7)5.2 (1.1)0.030
Colesterol total (mg/dl)168 (29)181 (32)0.165
Colesterol-HDL (mg/dl)51 (10)50 (14)0.712
Colesterol-LDL (mg/dl)102 (25)110 (27)0.300
TAG (mg/dl)74 (31)104 (52)0.043
ALT (U/l)18 (6)29 (16)0.024
Gamma-GT (U/l)16 (4)22 (5)<0.001
AST/ALT1.342 (0.282)0.950 (0.302)<0.001

Conclusion: Children with overweight and fatty liver disease are at increased cardiometabolic risk than having overweight or obese do not have an excessive accumulation of fat in the liver. The percentage of fat in the liver is associated with adiposity and total abdominal with insulin resistance.