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Alanine Aminotransferase Levels and Fatty Liver in Childhood Obesity: Associations with Insulin Resistance, Adiponectin, and Visceral Fat

Published on Nov 1, 2006in The Journal of Clinical Endocrinology and Metabolism5.61
· DOI :10.1210/jc.2006-1010
Tania S. Burgert14
Estimated H-index: 14
,
Sara E. Taksali19
Estimated H-index: 19
+ 9 AuthorsSonia Caprio65
Estimated H-index: 65
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Abstract
Findings: Elevated ALT (35 U/liter) was found in 14% of adolescents, with a predominance of male gender and white/Hispanic race/ ethnicity. After adjusting for potential confounders, rising ALT was associated with reduced insulin sensitivity and glucose tolerance as well as rising free fatty acids and triglycerides. Worsening of glucose and lipid metabolism was already evident as ALT levels rose into the upper half of the normal range (18–35 U/liter). When hepatic fat fraction was assessed using fast magnetic resonance imaging, 32% of subjects had an increased hepatic fat fraction, which was associated with decreased insulin sensitivity and adiponectin, and increased triglycerides, visceral fat, and deep to superficial sc fat ratio. The prevalence of the metabolic syndrome was significantly greater in those with fatty liver. Interpretation: Deterioration in glucose and lipid metabolism is associated even with modest ALT elevations. Hepatic fat accumulation in childhood obesity is strongly associated with the triad of insulin resistance, increased visceral fat, and hypoadiponectinemia. Hence, hepatic steatosis may be a core feature of the metabolic syndrome. (J Clin Endocrinol Metab 91: 4287–4294, 2006)
  • References (41)
  • Citations (279)
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References41
Newest
Published on Mar 1, 2006in Journal of Pediatric Gastroenterology and Nutrition3.02
Nahida El-Rifai3
Estimated H-index: 3
(SIU: Southern Illinois University Carbondale),
Nabil Daoud1
Estimated H-index: 1
(SIU: Southern Illinois University Carbondale)
+ 2 AuthorsFrancis Jaubert1
Estimated H-index: 1
Objective: Central adiposity, a component of insulin resistance syndrome, is a risk factor for nonalcoholic fatty liver disease (NAFLD) in adults. To determine whether a similar relationship occurs in children, hepatic fat content and adipose tissue distribution were assessed in obese children at risk for NAFLD. Methods: We reviewed the charts of obese children undergoing evaluation for NAFLD because of hepatomegaly or elevated serum alanine aminotransferase (ALT) without obvious etiology. Hepat...
Published on Jan 24, 2006in Annals of the New York Academy of Sciences4.29
Eric Ravussin16
Estimated H-index: 16
(Pennington Biomedical Research Center),
Steven R. Smith71
Estimated H-index: 71
(Pennington Biomedical Research Center)
Abstract: It is widely accepted that increasing adiposity is associated with insulin resistance and increased risk of type 2 diabetes. The predominant paradigm used to explain this link is the portal/visceral hypothesis. This hypothesis proposes that increased adiposity, particularly in the visceral depots, leads to increased free fatty acid flux and inhibition of insulin action via Randle's effect in insulin-sensitive tissues. Recent data do not entirely support this hypothesis. As such, two ne...
Published on Dec 1, 2005in The Journal of Pediatrics3.74
M. V. Louthan3
Estimated H-index: 3
(University of Louisville),
Shirish Barve39
Estimated H-index: 39
(University of Louisville)
+ 1 AuthorsSwati Joshi-Barve21
Estimated H-index: 21
(University of Louisville)
Objective To evaluate the relative concentrations of cytokines in pediatric nonalcoholic fatty liver disease (NAFLD). Study design Thirty children were evaluated at a fasting morning visit to a pediatric research unit. Results Compared with normal-weight children (n = 12) and children who were overweight (n = 11), children who had presumed NAFLD (elevated Alanine aminotransferase [ALT] with negative work-up) (n = 7) had significantly lower mean serum adiponectin levels ( P = .004). Adiponectin n...
Published on Sep 1, 2005in Hepatology14.97
Jeffrey B. Schwimmer48
Estimated H-index: 48
(UCSD: University of California, San Diego),
Cynthia Behling33
Estimated H-index: 33
(UCSD: University of California, San Diego)
+ 4 AuthorsJoel E. Lavine49
Estimated H-index: 49
(UCSD: University of California, San Diego)
Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are common in children and adolescents. However, standard histological criteria for pediatric NAFLD and NASH are undeveloped. We reviewed consecutive patients ages 2 to 18 years with biopsy-proven NAFLD diagnosed between 1997 and 2003. Biopsies were evaluated by two pathologists for individual features of steatohepatitis. Agglomerative hierarchical cluster analysis demonstrated two different forms of steatohepatitis...
Published on Jul 1, 2005in Journal of Pediatric Gastroenterology and Nutrition3.02
Kristen J. Nadeau28
Estimated H-index: 28
,
Georgeanna J. Klingensmith25
Estimated H-index: 25
,
P. Zeitler5
Estimated H-index: 5
ABSTRACTBackground:Nonalcoholic fatty liver disease, a cause of chronic liver disease in obese adults also occurs in obese children. In susceptible populations, fatty liver progresses to nonalcoholic steatohepatitis and eventually to fibrosis and cirrhosis. Nonalcoholic steatohepatitis is associated
Published on May 1, 2005in Pediatrics5.40
Jeffrey B. Schwimmer48
Estimated H-index: 48
,
Nancy McGreal4
Estimated H-index: 4
+ 2 AuthorsJoel E. Lavine49
Estimated H-index: 49
Objectives. Fatty liver is a common cause of liver disease in children. However, the epidemiology of pediatric fatty liver is limited to single-center case series of nonalcoholic fatty liver disease (NAFLD). Obesity and insulin resistance are major established risk factors for NAFLD. The role of gender, race, and ethnicity on the prevalence of fatty liver in obese children is unknown. Methods. We recruited obese 12th-grade participants from the Child and Adolescent Trial for Cardiovascular Healt...
Lidia S. Szczepaniak26
Estimated H-index: 26
(UTSW: University of Texas Southwestern Medical Center),
Pamela Nurenberg8
Estimated H-index: 8
(UTSW: University of Texas Southwestern Medical Center)
+ 5 AuthorsRobert L. Dobbins21
Estimated H-index: 21
(UTSW: University of Texas Southwestern Medical Center)
Despite the increasing prevalence of nonalcoholic fatty liver disease (NAFLD), the criteria used to diagnose the disorder remain poorly defined. Localized proton magnetic resonance spectroscopy (MRS) accurately measures hepatic triglyceride content (HTGC) but has been used only in small research studies. Here, MRS was used to analyze the distribution of HTGC in 2,349 participants from the Dallas Heart Study (DHS). The reproducibility of the procedure was validated by showing that duplicate HTGC ...
Published on Nov 1, 2004in Diabetes7.20
Naveed Sattar115
Estimated H-index: 115
(Glas.: University of Glasgow),
Olga Scherbakova4
Estimated H-index: 4
+ 7 AuthorsJames Shepherd76
Estimated H-index: 76
We examined the association of serum alanine aminotransferase (ALT) with features of the metabolic syndrome and whether it predicted incident diabetes independently of routinely measured factors in 5,974 men in the West of Scotland Coronary Prevention Study. A total of 139 men developed new diabetes over 4.9 years of follow-up. ALT, but not aspartate aminotransferase, levels increased progressively with the increasing number of metabolic syndrome abnormalities from (means ± SD) 20.9 ± 7.6 units/...
Published on Oct 1, 2004in International Journal of Obesity4.51
Dorothy F.Y. Chan12
Estimated H-index: 12
(CUHK: The Chinese University of Hong Kong),
Albert Martin Li Mb44
Estimated H-index: 44
(CUHK: The Chinese University of Hong Kong)
+ 8 AuthorsFOKTaiFai49
Estimated H-index: 49
(CUHK: The Chinese University of Hong Kong)
OBJECTIVES: The aims of our study were: (1) to determine the prevalence of asymptomatic hepatic steatosis and presumed nonalcoholic steatohepatitis, in our local population of obese Chinese children referred for medical assessment; and (2) to assess the correlation between severity of ultrasonographic hepatic steatosis and degree of obesity, insulin resistance and serum biochemical abnormalities. DESIGN: Cross-sectional study. METHODS: In total, 84 obese children, 25 girls and 59 boys with media...
Cited By279
Newest
Published on Dec 1, 2019in BMC Gastroenterology2.25
Feryal Savari (Ahvaz Jundishapur University of Medical Sciences), Seyyed Ali Mard7
Estimated H-index: 7
(Ahvaz Jundishapur University of Medical Sciences)
+ 2 AuthorsMohammad Kazem Gharib-Naseri5
Estimated H-index: 5
(Ahvaz Jundishapur University of Medical Sciences)
Background General overnutrition is one of the key factors involved in the development of nonalcoholic fatty liver disease (NAFLD) as the most common liver disease occur by two steps of liver injury ranges from steatosis to nonalcoholic steatohepatitis (NASH). Here the effect of fructose, fat-rich and western diet (WD) feeding was studied along with aggravative effect of cigarette smoking on liver status in mice.
Published on Jun 1, 2019in European Journal of Pediatrics2.19
Laura G. Draijer1
Estimated H-index: 1
(Boston Children's Hospital),
Sana Feddouli1
Estimated H-index: 1
(Boston Children's Hospital)
+ 5 AuthorsBart Koot11
Estimated H-index: 11
(Boston Children's Hospital)
Alanine aminotransferase (ALT) and ultrasound (US) are the most commonly used tools for detecting non-alcoholic fatty liver disease (NAFLD). No direct comparison of these two modalities in children exists. We aimed to compare head-to-head the diagnostic accuracy of ALT and US and their combination for detecting NAFLD in children with obesity. Ninety-nine children with severe obesity underwent simultaneous serum-ALT and abdominal ultrasound (US steatosis score 0–3). Proton magnetic resonance spec...
Published on May 28, 2019
Flora Tzifi1
Estimated H-index: 1
(UoA: National and Kapodistrian University of Athens),
Andreas Fretzayas11
Estimated H-index: 11
+ 1 AuthorsChristina Kanaka-Gantenbein20
Estimated H-index: 20
(UoA: National and Kapodistrian University of Athens)
Non-alcoholic fatty liver disease (NAFLD) constitutes the most common liver disease, one that is still underdiagnosed in pediatric populations (as well as in the general population), this due to the progressive increase in childhood obesity observed both in developed and developing countries during the last few decades. The pathophysiology of the disease has not been thoroughly clarified yet. The condition displays common pathways in adults and children; however, there are age-related difference...
Published on May 4, 2019in Expert Review of Gastroenterology & Hepatology2.99
Laura G. Draijer1
Estimated H-index: 1
(Boston Children's Hospital),
Marc A. Benninga53
Estimated H-index: 53
(Boston Children's Hospital),
Bart Koot11
Estimated H-index: 11
(Boston Children's Hospital)
Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and adults in industrialized countries. Besides liver-related morbidity, NAFLD is also associated with an increased risk of cardiovascular disease, type 2 diabetes and mortality at adult age. However, despite the high prevalence and serious complications, diagnosing and staging of disease remains complicated due to a lack of accurate screening tools and non-invasive methods to detect fibr...
Published on May 1, 2019in Diabetes, Obesity and Metabolism6.13
Dharambir K. Sanghera30
Estimated H-index: 30
,
Cynthia Bejar (University of Oklahoma Health Sciences Center)+ 2 AuthorsPiers R. Blackett17
Estimated H-index: 17
(University of Oklahoma Health Sciences Center)
Published on Apr 1, 2019in International Journal of Obesity4.51
Giuseppina Rosaria Umano4
Estimated H-index: 4
(Yale University),
Veronika Shabanova9
Estimated H-index: 9
(Yale University)
+ 6 AuthorsSonia Caprio65
Estimated H-index: 65
(Yale University)
The relative proportion of visceral fat (VAT) to subcutaneous fat (SAT) has been described as a major determinant of insulin resistance (IR). Our study sought to evaluate the effect of body fat distribution on glucose metabolism and intrahepatic fat content over time in a multiethnic cohort of obese adolescents. We examined markers of glucose metabolism by oral glucose tolerance test, and body fat distribution by abdominal MRI at baseline and after 19.2 ± 11.4 months in a cohort of 151 obese ado...
Published on Jan 1, 2019in Journal of Clinical Lipidology3.58
Mathilde Di Filippo1
Estimated H-index: 1
(UCBL: Claude Bernard University Lyon 1),
Mathilde Varret12
Estimated H-index: 12
(Paris Diderot University)
+ 10 AuthorsFrancisca Joly26
Estimated H-index: 26
(University of Paris)
Background Abetalipoproteinemia, a recessive disease resulting from deleterious variants in MTTP (microsomal triglyceride transfer protein), is characterized by undetectable concentrations of apolipoprotein B, extremely low levels of low-density lipoprotein cholesterol in the plasma, and a total inability to export apolipoprotein B–containing lipoproteins from both the intestine and the liver. Objective To study lipid absorption after a fat load and liver function in 7 heterozygous relatives fro...
Published on Dec 1, 2018in Lipids in Health and Disease2.65
Dianhui Wang2
Estimated H-index: 2
(SDU: Shandong University),
Ling Wang1
Estimated H-index: 1
+ 3 AuthorsDongqing Jiang2
Estimated H-index: 2
(SDU: Shandong University)
Non-HDL-cholesterol to HDL-cholesterol (non-HDL-c/HDL-c) ratio is a feasible predictor for coronary heart disease, metabolic syndrome, and insulin resistance. Patients with nonalcoholic steatohepatitis (NASH) have an increased risk of developing cardiovascular problems and type 2 diabetes. However, the predictive role of non-HDL-c/HDL-c ratio in NASH hasn’t been investigated yet. We conducted a retrospective cohort study. A total of 3489 eligible subjects were selected in the present study. Prev...
Published on Dec 1, 2018in Implementation Science4.53
Justin D. Smith15
Estimated H-index: 15
(NU: Northwestern University),
Cady Berkel13
Estimated H-index: 13
(ASU: Arizona State University)
+ 10 AuthorsJenna Rudo-Stern3
Estimated H-index: 3
(ASU: Arizona State University)
Pediatric obesity is a multi-faceted public health concern that can lead to cardiovascular diseases, cancers, and early mortality. Small changes in diet, physical activity, or BMI can significantly reduce the possibility of developing cardiometabolic risk factors. Family-based behavioral interventions are an underutilized, evidence-based approach that have been found to significantly prevent excess weight gain and obesity in children and adolescents. Poor program availability, low participation ...
Published on Oct 27, 2018in World Journal of Hepatology
Wanvisa Udomsinprasert7
Estimated H-index: 7
,
Sittisak Honsawek17
Estimated H-index: 17
,
YongPoovorawan46
Estimated H-index: 46