TY - JOUR

T1 - Alterations in ventricular structure and function in obese adolescents with nonalcoholic fatty liver disease

AU - Singh, Gautam K

AU - Vitola, Bernadette E

AU - Holland, Mark R

AU - Sekarski, Timothy

AU - Patterson, Bruce W

AU - Magkos, Faidon

AU - Klein, Samuel

N1 - Copyright © 2013 Mosby, Inc. All rights reserved.

PY - 2013

Y1 - 2013

N2 - Objective: To determine the association among nonalcoholic fatty liver disease (NAFLD), metabolic function, and cardiac function in obese adolescents.Sstudy 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.

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

KW - Adolescent

KW - Body Mass Index

KW - Cross-Sectional Studies

KW - Fatty Liver/metabolism

KW - Female

KW - Heart Ventricles/pathology

KW - Humans

KW - Insulin Resistance

KW - Liver/metabolism

KW - Magnetic Resonance Spectroscopy

KW - Male

KW - Non-alcoholic Fatty Liver Disease

KW - Obesity/complications

KW - Triglycerides/metabolism

U2 - 10.1016/j.jpeds.2012.11.024

DO - 10.1016/j.jpeds.2012.11.024

M3 - Journal article

C2 - 23260104

VL - 162

SP - 1160-1168 + 1168.e1

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

IS - 6

ER -