Alterations in ventricular structure and function in obese adolescents with nonalcoholic fatty liver disease
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Alterations in ventricular structure and function in obese adolescents with nonalcoholic fatty liver disease. / Singh, Gautam K; Vitola, Bernadette E; Holland, Mark R; Sekarski, Timothy; Patterson, Bruce W; Magkos, Faidon; Klein, Samuel.
In: Journal of Pediatrics, Vol. 162, No. 6, 2013, p. 1160-1168 + 1168.e1.Research output: Contribution to journal › Journal article › Research › peer-review
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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 -
ID: 289973265