Relationship between nonalcoholic fatty liver disease and cardiovascular disease in children with obesity

LIU Li-Rui; FU Jun-Fen; LIANG Li; HUANG Ke

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Chinese Journal of Contemporary Pediatrics ›› 2010, Vol. 12 ›› Issue (07) : 547-550.

CLINICAL RESEARCH

Relationship between nonalcoholic fatty liver disease and cardiovascular disease in children with obesity

LIU Li-Rui, FU Jun-Fen, LIANG Li, HUANG Ke

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Abstract

OBJECTIVE: To study the relationship between nonalcoholic fatty liver disease (NAFLD) and the development of cardiovascular disease (CVD) in children with obesity. METHODS: Two hundred and thirty-one obese children and 24 non-obese children as control were enrolled. Body mass index (BMI), serum triglyceride, blood pressure, liver function, and carotid artery intima-media thickness (IMT) were examined. The obese children were classified into two subgroups according to the diagnosis criteria: group 1 without liver disorder (OCWLD group, n=75) and group 2 with NAFLD (NAFLD group, n=156). The incidences of hyperlipidemia and hypertension, carotid artery intima-media thickness (IMT) and biochemical indicators were compared in the three groups. RESULTS: The NAFLD group showed significantly greater carotid IMT (0.066±0.021 cm) than the OCWLD (0.060±0.011 cm) and control groups (0.037±0.007 cm) (P<0.05). The OCWLD group had also thicker IMT than the control group (P<0.05). The incidences of hyperlipidemia and hypertension were 39.7% and 40.4%, respectively in the NAFLD group, which were significantly higher than those in the OCWLD (22.7% and 29.3% respectively)and control groups (4.2% and 12.6% respectively) (P<0.05). The liner stepwise regression analysis showed that the IMT was positively correlated with BMI, NAFLD and ALT (adjusted R2=0.316, P<0.01). CONCLUSIONS: NAFLD may be not only an early marker but also an early state of CVD in obese children. Early diagnosis and treatment of NAFLD is crucial for the prevention of the occurrence and development of CVD.［Chin J Contemp Pediatr, 2010, 12 (7):547-550］

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Obesity / Nonalcoholic fatty liver disease / Cardiovascular disease / Carotid artery intima-media thickness / Child

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LIU Li-Rui, FU Jun-Fen, LIANG Li, HUANG Ke. Relationship between nonalcoholic fatty liver disease and cardiovascular disease in children with obesity[J]. Chinese Journal of Contemporary Pediatrics. 2010, 12(07): 547-550

References

［1］Grant LM, Lisker-Melman M. Nonalcoholic fatty liver disease ［J］. Ann Hepatol, 2004, 3(3): 93-99.
［2］Targher G, Arcaro G. Non-alcoholic fatty liver disease and increased risk of cardiovascular disease ［J］. Atherosclerosis, 2007, 191(2): 235-240.
［3］Schwimmer JB, Deutsch R,Behling C, Lavine JE. Fatty liver as a determinant of atherosclerosis ［J］. Hepatology, 2005, 42: 610A.
［4］唐海滨, 胡艳文, 韦旻,刘鲲.老年人非酒精性脂肪性肝病与心血管疾病的临床分析［J］.贵州医药, 2006, 30（5）:419-420.
［5］Hamaguchif M, Kojimal T, Takedal N, Nagatal C, Takedal J, Sarui H, et al. Nonalcoholic fatty liver disease is a novel predictor of cardiovascular disease ［J］. World J Gastroenterol, 2007, 13(10): 1579-1584.
［6］Schwimmer JB, Pardee PE, Lavine JE, Blumkin AK, Cook S. Cardiovascular risk factors and the metabolic syndrome in pediatric nonalcoholic fatty liver disease ［J］. Circulation, 2008, 118(3):277-283.
［7］中国学生体质与健康研究组.2005年中国学生体质与健康调研报告［M］.北京:高等教育出版社, 2007: 178-183,193-198,220-222.
［8］中华医学会肝脏病学分会脂肪肝和酒精性脂肪肝病学组. 非酒精性脂肪肝病诊疗指南［J］. 中华肝脏病杂志，2006，14（3）：161-163.
［9］Tazawa Y, Noguchi H, Nishinomiya F, Takada G. Serum alanine aminotrasferase acivity in obese children ［J］. Acta Paediatr, 1997, 86 (3):238-241.
［10］傅君芬，梁黎，王春林，洪芳，董关萍，李筠.肥胖儿童非酒精性脂肪肝炎发病状况及机制探讨［J］.浙江大学学报（医学版），2006，35（1）：64-68.
［11］Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, Girardet JP, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study ［J］. Lancet, 2001, 358(9291); 1400-1404.
［12］Bots ML, Baldassarre D, Simon A, de Groot E, O'Leary DH, Riley W, et al. Carotid intimamedia thickness and coronary atherosclerosis: weak or strong relations？［J］. Europe Heart, 2007, 28 (4):398-406.
［13］Brea A, Mosquera D, Martín E, Arizti A, Cordero JL, Ros E. Nonalcoholic fatty liver disease is associated with carotid atherosclerosis ［J］. Arterioscler Thromb, 2005, 25(5)：1045-1050.
［14］Targher G, Bertolini L, Padovani R, Rodella S, Zoppini G, Zenari L, et al. Relations between carotid artery wall thickness and liver histology in subjects with nonalcoholic fatty liver disease ［J］. Diabetes Care, 2006, 29 (6): 1325-1330.
［15］Schindhelm RK, Dekker JM, Nijpels G, Bouter LM, Stehouwer CD, Heine RJ, et al. Alanine aminotransferase predicts coronary heart disease events: a 10-year follow-up of the Hoorn Study ［J］.Atherosclerosis, 2007, 191 (2): 391-396.
［16］YkiJarvinen H, Westerbacka J. The fatty liver and insulin resistance ［J］. Curr Mol Med, 2005, 5(3):287-295.
［17］Targher G, Arcaro G. Non-alcoholic fatty liver disease and increased risk of cardiovascular disease ［J］. Atherosclerosis, 2007, 191(2): 235-240.
［18］Patel S, Celermajer DS, Bao S. Atherosclerosis-underlying inflammatory mechanisms and clinical implications ［J］. Int J Biochem Cell Biol, 2008, 40 (4):576-580.
［19］Jiang LL, Li L, Hong XF, Li YM, Zhang BL. Patients with nonalcoholic fatty liver disease display increased serum resistin levels and decreased adiponectin levels ［J］. Eur J Gastroenterol Hepatol, 2009, 21(6):662-666.
［20］Matsuzawa Y, Funahashi T, Kihara S, Shimomura I. Adiponectin and metabolic syndrome ［J］. Arterioscler Thromb Vasc Biol, 2004, 24(1): 29-33.
［21］Musso G, Gambino R, De Michieli F, Cassader M, Rizzetto M, Durazzo M, et al. Dietary habits and their relations to insulin resistance and postprandial lipemia in nonalcoholic steatohepatitis ［J］. Hepatology, 2003, 37(4): 909-916.