Faculty Collaboration Database

Alterations in ventricular structure and function in obese adolescents with nonalcoholic fatty liver disease. J Pediatr 2013 Jun;162(6):1160-8, 1168.e1

Date

12/25/2012

Pubmed ID

23260104

Pubmed Central ID

PMC3615145

DOI

10.1016/j.jpeds.2012.11.024

Scopus ID

2-s2.0-84880573350 (requires institutional sign-in at Scopus site)   61 Citations

Abstract

OBJECTIVE: To determine the association among nonalcoholic fatty liver disease (NAFLD), metabolic function, and cardiac function in obese adolescents.

STUDY DESIGN: Intrahepatic triglyceride (IHTG) content (magnetic resonance spectroscopy), insulin sensitivity and β-cell function (5-hour oral glucose tolerance test with mathematical modeling), and left ventricular function (speckle tracking echocardiography) were determined in 3 groups of age, sex, and Tanner matched adolescents: (1) lean (n=14, body mass index [BMI]=20±2 kg/m2); (2) obese with normal (2.5%) IHTG content (n=15, BMI=35±3 kg/m2); and (3) obese with increased (8.7%) IHTG content (n=15, BMI=37±6 kg/m2).

RESULTS: The disposition index (β-cell function) and insulin sensitivity index were ∼45% and ∼70% lower, respectively, and whole body insulin resistance, calculated by homeostasis model of assessment-insulin resistance (HOMA-IR), was ∼60% greater, in obese than in lean subjects, and ∼30% and ∼50% lower and ∼150% greater, respectively, in obese subjects with NAFLD than those without NAFLD (P<.05 for all). Left ventricular global longitudinal systolic strain and early diastolic strain rates were significantly decreased in obese than in lean subjects, and in obese subjects with NAFLD than those without NAFLD (P<.05 for all), and were independently associated with HOMA-IR (β=0.634). IHTG content was the only significant independent determinant of insulin sensitivity index (β=-0.770), disposition index (β=-0.651), and HOMA-IR (β=0.738).

CONCLUSIONS: These findings demonstrate that the presence of NAFLD in otherwise asymptomatic obese adolescents is an early marker of cardiac dysfunction.

Author List

Singh GK, Vitola BE, Holland MR, Sekarski T, Patterson BW, Magkos F, Klein S

Author

Bernadette Vitola MD, MPH Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Body Mass Index
Cross-Sectional Studies
Fatty Liver
Female
Heart Ventricles
Humans
Insulin Resistance
Liver
Magnetic Resonance Spectroscopy
Male
Non-alcoholic Fatty Liver Disease
Obesity
Triglycerides