ESPE Abstracts (2018) 89 P-P3-140

Hepatic Steatosis and its Relationship with the Metabolic Syndrome

Maria Angeles Santos Mataa & Irene Pilar Fernandez Viserasb


aHospital Sas De Jerez De La Frontera, Jerez De La Frontera, Spain; bHospital Virgen Del Camino Sanlucar De Barrameda, Sanlucar De Barrameda, Spain


Introduction: Hepatic steatosis(HS) is a frequent finding in obese children. Insulin resistance, hypertriglyceridemia and abdominal circumference (AC) are known risk factors, similar to Metabolic Syndrome (MS), but the precise pathophysyology remains unexplained.

Objectives: To analyze the prevalence of HS as identified by ultrasound as well as acanthosis Nigricans (AN) in two groups of obese patients; with or without presence of MS; by studying anthropometric, analytical characteristics and waist-length-ratio (WLR).

Material and methods: In this descriptive cross-sectional study, 190 children aged 5–14 with BMI>2SD where evaluated. Those patients with secondary causes of obesity have been excluded as HS due to other causes. We analyze somatometry, biochemical parameters (glucose, insulin, lipid profile, hepatic transaminases, HOMA, uric acid), as well as the presence or absence of acanthosis nigricans (AN) in both groups. Liver ultrasound was performed to define the presence or absence of steatosis and we have followed the classification IDF, to define the presence of MS in patients older than 11 years of age. All patients underwent an oral glucose tolerance test (OGTT). The statistical analysis was performed in SPSS 17.

Results: The cohort of 190 patients was equally weighted with respect to sex. The prevalence of HS was 36.8% (60% males vs 40% women). Metabolic criteria of MS are presented in the 36% (n=25) of patients with HS vs 11% without HS (n=13). There is positive correlation (R=0.78) between patients with metabolic syndrome and hepatic steatosis (P<0.05).

Table 1
HSWITHOUT HS
N70120
AGE13+/−1.710.4+/−1.5P<0.05
BMI31.7+/−2.226.7+/−1.3P<0.005
SD OF BMI4.63.1P<0.05
AC100+/−890+/−15P<0.005
INSULIN18.5+/−3.514+/−5.5P<0.05
HOMA3.8+/−1.52.8+/−1.1P=0.003
CHOLESTEROL160+/−20157+/−17Non significant
HDL39+/−448.8+/−3.8P=0.003
TRIGLICERIDES153+/−6.474+/−5.3P<0.005
URIC ACID5.9+/−0.244+/−0.1P=0.005
GOT40+/−4.726+/−2P<0.005
GPT39+/−3.837+/−1.5P<0.05
ACANTHOSIS NIGRICANS80%20%P<0.001
WAIST LENGTH RATIO0.78+/−0.10.55+/−0.2P<0.05

Conclusions: The prevalence of HS in our population is higher than previously published. Our results show that HS is related to BMI, AC, hypertriglyceridemia and HOMA index. We observed higher waist-length ratio in the population with HS and a higher incidence of MS. AN is also more prevalent in those patients with HS.

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