Relationship between fatty liver and glucose metabolism: A cross-sectional study in 571 obese children

G. Bedogni, A. Gastaldelli, M. Manco, A. De Col, F. Agosti, C. Tiribelli, A. Sartorio

Research output: Contribution to journalArticle

Abstract

Background and aims: Early onset type 2 diabetes mellitus (T2DM) is associated with obesity, insulin resistance and impaired beta-cell function. Non-alcoholic fatty liver disease (NAFLD) may be an independent risk factor for T2DM. We investigated the relationship between NAFLD and glucose metabolism in a large sample of obese children. Methods and Results: A total of 571 obese children (57% males and 43% females) aged 8-18 years were consecutively studied at a tertiary care centre specialised in paediatric obesity. Liver ultrasonography was used to diagnose NAFLD after exclusion of hepatitis B and C and alcohol consumption. Oral-glucose tolerance testing (OGTT) was performed; insulin sensitivity was evaluated by using the insulin sensitivity index (ISI) and beta-cell function by using the ratio between the incremental areas under the curve (AUC) of insulin and glucose (incAUCins/incAUCglu). A total of 41% of the obese children had NAFLD. Impaired glucose tolerance or T2DM was present in 25% of the children with NAFLD versus 8% of those without it (p<0.001). Children with NAFLD had higher body mass index (BMI), fasting glucose, 120-min OGTT glucose, incAUCins/incAUCglu and lower ISI as compared with children without NAFLD (p≤ 0.002). At bootstrapped multivariable median regression analysis controlling for gender, age, pubertal status and BMI, NAFLD was an independent predictor of 120-min OGTT glucose and ISI, but not of incAUCins/incAUCglu. Similar findings were obtained using continuous liver steatosis as the predictor, instead of dichotomous NAFLD. Conclusion: NAFLD was present in 41% of our obese children and was associated with higher insulin resistance, but not with impaired beta-cell function.

Original languageEnglish
Pages (from-to)120-126
Number of pages7
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume22
Issue number2
DOIs
Publication statusPublished - Feb 2012

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Keywords

  • Children
  • Impaired glucose tolerance
  • Insulin resistance
  • Non-alcoholic fatty liver disease
  • Obesity
  • Oral-glucose tolerance test
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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