ESPE Abstracts

Introduction: An increase in liver enzymes predicts cardiac hypertrophy secondary to increased left ventricular mass in patients with cardiovascular disease. The mechanisms involved include decreased adiponectin concentration and increased epicardial fat in these subjects. We hypothesized that associations between these parameters would also be readily apparent in otherwise healthy children.

Objectives: Our objective was to study the associations between the liver enzymes alanine transaminase (ALT) and gamma-glutamyl transferase (GGT), left ventricular mass, high molecular weight adiponectin (HMW) and epicardial fat in apparently healthy children.

Subjects and methods: A total of 174 apparently healthy children (98 boys and 76 girls; age 9.4 ± 1.8 years) were recruited from primary health care centers in Girona (Northeastern Spain). Anthropometric parameters were measured: body mass, height and body mass index (BMI), and fasting venous blood was sampled to quantify ALT, GGT, and HMW-adiponectin serum levels. To assess epicardial fat, cardiac ultrasonography was performed following the recommendations of the American Society of Echocardiography. Left ventricular mass was derived from the following ultrasound parameters: interventricular septal thickness, left ventricular posterior wall thickness and the internal diameter of the left ventricle (Devereaux's formula).

Results: Liver enzymes were positively associated with left ventricular mass in these children: ALT (r= 0.297, P<0.0001) and GGT (r= 0.297, P<0.0001). In turn, HMW adiponectin was negatively associated with both GGT (r= -0.215, P=0.007) and left ventricular mass (r= -0.285, P<0.001), while epicardial fat was positively associated with both liver enzymes [ALT (r= 0.169, P=0.027) and GGT (r= 0.327, P<0.0001)] and left ventricular mass (r= 0.357, P<0.00001). All these associations were independent from potential confounding variables in multiple linear regression analyses.

Conclusions: Higher liver enzyme values are associated with increased left ventricular mass in apparently healthy children. Lower HMW-adiponectin concentration and higher epicardial fat in these children may contribute to explain these associations. These results justify the need for longitudinal studies in children to prevent the increased risk for cardiovascular disease associated with liver dysfunction.