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01.12.2007 | Obesity

Prevalence of non-alcoholic fatty liver and characteristics in overweight adolescents in the general population

verfasst von: Armin Imhof, Wolfgang Kratzer, Bernhard Boehm, Katrin Meitinger, Gerlinde Trischler, Gerald Steinbach, Isolde Piechotowski, Wolfgang Koenig

Erschienen in: European Journal of Epidemiology | Ausgabe 12/2007

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Abstract

Overweight and obesity among children and adolescents are increasing. Fatty liver disease (FLD) is an emerging problem in this age group. We investigated prevalence of overweight and non-invasive FLD and associated clinical characteristics in a representative population-based sample of 378 children and adolescents aged 12–20 years who were randomly selected from the general population in Leutkirch, Southern Germany. Overweight was defined as having a body mass index above the 90th percentile for the respective age and sex. About 15% of female (29 out of 194) and 12% of male participants (22/182) were overweight. Among females, only one non-overweight individual showed signs of FLD but in more than one third of the overweight males (8/22) signs of FLD were present. Overweight subjects in general had an unfavourable lipid profile and abnormal concentrations of obesity-related hormones such as significantly lower concentrations of adiponectin and increased levels of inflammatory markers including C-reactive protein and fibrinogen. Overweight males with signs of FLD showed even more severe altered metabolic responses compared to those who were overweight without signs of liver injury. FLD was not explained by alcohol consumption or other chronic liver disease. In this sample of children and adolescents representative of the general population a high prevalence of non-alcoholic fatty liver disease (NAFLD) is found in overweight males. These individuals showed the most severe metabolic alterations compared to non-overweight and overweight individuals without NAFLD indicating even higher risk for future overweight and obesity-related diseases such as type 2 diabetes and cardiovascular disease.

WHO World Health Organisation. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation, Geneva, 3–5 June 1997; 1998.

Berenson GS, Srinivasan SR, Wattigney WA, Harsha DW. Obesity and cardiovascular risk in children. Ann N Y Acad Sci 1993;699:93–103.PubMedCrossRef

Caprio S. Insulin resistance in childhood obesity. J Pediatr Endocrinol Metab 2002;15 Suppl 1:487–92.PubMed

de Ferranti SD, Gauvreau K, Ludwig DS, et al. Prevalence of the metabolic syndrome in American adolescents. Findings from the third National Health and Nutrition Examination Survey. Circulation 2004;110:2494–7.PubMedCrossRef

Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362–74.PubMedCrossRef

Executive summary of the third report of the national cholesterol education program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA 2001;285:2486–97.

Lavine JE, Schwimmer JB. Nonalcoholic fatty liver disease in the pediatric population. Clin Liver Dis 2004;8:549–58, viii–ix.PubMedCrossRef

Schwimmer JB, Deutsch R, Kahen T, et al. Prevalence of fatty liver in children and adolescents. Pediatrics 2006;118:1388–93.PubMedCrossRef

Tominaga K, Kurata JH, Chen YK, et al. Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey. Dig Dis Sci 1995;40:2002–9.PubMedCrossRef

10.

Shen L, Fan JG, Shao Y, et al. Prevalence of nonalcoholic fatty liver among administrative officers in Shanghai: an epidemiological survey. World J Gastroenterol 2003;9:1106–10.PubMed

11.

Schwimmer JB, Deutsch R, Rauch JB, et al. Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. J Pediatr 2003;143:500–5.PubMedCrossRef

12.

Nakao K, Nakata K, Ohtsubo N, et al. Association between nonalcoholic fatty liver, markers of obesity, and serum leptin level in young adults. Am J Gastroenterol 2002;97:1796–801.PubMedCrossRef

13.

Vozarova B, Stefan N, Lindsay RS, et al. High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes. Diabetes 2002;51:1889–95.PubMedCrossRef

14.

Hanley AJ, Williams K, Festa A, et al. Elevations in markers of liver injury and risk of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes 2004;53:2623–32.PubMedCrossRef

15.

Targher G, Bertolini L, Poli F, et al. Nonalcoholic fatty liver disease and risk of future cardiovascular events among type 2 diabetic patients. Diabetes 2005;54:3541–6.PubMedCrossRef

16.

Akahoshi M, Amasaki Y, Soda M, et al. Correlation between fatty liver and coronary risk factors: a population study of elderly men and women in Nagasaki, Japan. Hypertens Res 2001;24:337–43.PubMedCrossRef

17.

Kim HJ, Lee KE, Kim DJ, et al. Metabolic significance of nonalcoholic fatty liver disease in nonobese, nondiabetic adults. Arch Intern Med 2004;164:2169–75.PubMedCrossRef

18.

Kim SG, Kim HY, Seo JA, et al. Relationship between serum adiponectin concentration, pulse wave velocity and nonalcoholic fatty liver disease. Eur J Endocrinol 2005;152:225–31.PubMedCrossRef

19.

Brea A, Mosquera D, Martin E, et al. Nonalcoholic fatty liver disease is associated with carotid atherosclerosis. A case–control study. Arterioscler Thromb Vasc Biol 2005;12:518–9.

20.

Targher G, Bertolini L, Padovani R, et al. Relations between carotid artery wall thickness and liver histology in subjects with nonalcoholic fatty liver disease. Diabetes Care 2006;29:1325–30.PubMedCrossRef

21.

Cook DG, Mendall MA, Whincup PH, et al. C-reactive protein concentration in children: relationship to adiposity and other cardiovascular risk factors. Atherosclerosis 2000;149:139–50.PubMedCrossRef

22.

Koenig W, Lowel H, Baumert J, Meisinger C. C-reactive protein modulates risk prediction based on the Framingham Score: implications for future risk assessment: results from a large cohort study in southern Germany. Circulation 2004;109:1349–53.PubMedCrossRef

23.

Danesh J, Collins R, Appleby P, Peto R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA 1998;279:1477–82.PubMedCrossRef

24.

Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr 2004;92:347–55.PubMedCrossRef

25.

Satoh N, Naruse M, Usui T, et al. Leptin-to-adiponectin ratio as a potential atherogenic index in obese type 2 diabetic patients. Diabetes Care 2004;27:2488–90.PubMedCrossRef

26.

Meier U, Gressner AM. Endocrine regulation of energy metabolism: review of pathobiochemical and clinical chemical aspects of leptin, ghrelin, adiponectin, and resistin. Clin Chem 2004;50:1511–25.PubMedCrossRef

27.

Tschop M, Smiley DL, Heiman ML. Ghrelin induces adiposity in rodents. Nature 2000;407:908–13.PubMedCrossRef

28.

Li WG, Gavrila D, Liu X, et al. Ghrelin inhibits proinflammatory responses and nuclear factor-kappaB activation in human endothelial cells. Circulation 2004;109:2221–6.PubMedCrossRef

29.

Marchesini G, Pagotto U, Bugianesi E, et al. Low ghrelin concentrations in nonalcoholic fatty liver disease are related to insulin resistance. J Clin Endocrinol Metab 2003;88:5674–9.PubMedCrossRef

30.

Koenig W, Khuseyinova N, Lowel H, Trischler G, Meisinger C. Lipoprotein-associated phospholipase A2 adds to risk prediction of incident coronary events by C-reactive protein in apparently healthy middle-aged men from the general population: results from the 14-year follow-up of a large cohort from southern Germany. Circulation 2004;110:1903–8.PubMedCrossRef

31.

Haenle MM, Brockmann SO, Kron M, et al. Overweight, physical activity, tobacco and alcohol consumption in a cross-sectional random sample of German adults. BMC Public Health 2006;6:233.PubMedCrossRef

32.

Jugendalter AAiK-u. Leitlinien der Arbeitsgemeinschaft Adipositas im Kindes- und Jugendalter. Available at: http://www.a-g-a.de 2003.

33.

Saverymuttu SH, Joseph AE, Maxwell JD. Ultrasound scanning in the detection of hepatic fibrosis and steatosis. Br Med J (Clin Res Ed) 1986;292:13–5.CrossRef

34.

Joseph AE, Saverymuttu SH, al-Sam S, Cook MG, Maxwell JD. Comparison of liver histology with ultrasonography in assessing diffuse parenchymal liver disease. Clin Radiol 1991;43:26–31.PubMedCrossRef

35.

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18:499–502.PubMed

36.

Dada N, Kim NW, Wolfert RL. Lp-PLA2: an emerging biomarker of coronary heart disease. Expert Rev Mol Diagn 2002;2:17–22.PubMedCrossRef

37.

Lobstein T, Frelut ML. Prevalence of overweight among children in Europe. Obes Rev 2003;4:195–200.PubMedCrossRef

38.

Kalies H, Lenz J, von Kries R. Prevalence of overweight and obesity and trends in body mass index in German pre-school children, 1982–1997. Int J Obes Relat Metab Disord 2002;26:1211–7.PubMedCrossRef

39.

Schwimmer JB, McGreal N, Deutsch R, Finegold MJ, Lavine JE. Influence of gender, race, and ethnicity on suspected fatty liver in obese adolescents. Pediatrics 2005;115:e561–5.PubMedCrossRef

40.

Festa A, Williams K, Tracy RP, Wagenknecht LE, Haffner SM. Progression of plasminogen activator inhibitor-1 and fibrinogen levels in relation to incident type 2 diabetes. Circulation 2006;113:1753–9.PubMedCrossRef

41.

Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA 2001;286:327–34.PubMedCrossRef

42.

Koenig W. Fibrin(ogen) in cardiovascular disease: an update. Thromb Haemost 2003;89:601–9.PubMed

43.

Aldhahi W, Hamdy O. Adipokines, inflammation, and the endothelium in diabetes. Curr Diab Rep 2003;3:293–8.PubMedCrossRef

44.

Lyon CJ, Law RE, Hsueh WA. Minireview: adiposity, inflammation, and atherogenesis. Endocrinology 2003;144:2195–200.PubMedCrossRef

45.

Spranger J, Kroke A, Mohlig M, et al. Adiponectin and protection against type 2 diabetes mellitus. Lancet 2003;361:226–8.PubMedCrossRef

46.

Duncan BB, Schmidt MI. The epidemiology of low-grade chronic systemic inflammation and type 2 diabetes. Diabetes Technol Ther 2006;8:7–17.PubMedCrossRef

47.

Pischon T, Girman CJ, Hotamisligil GS, et al. Plasma adiponectin levels and risk of myocardial infarction in men. JAMA 2004;291:1730–7.PubMedCrossRef

48.

James J, Thomas P, Cavan D, Kerr D. Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial. BMJ 2004;328:1237.PubMedCrossRef

Titel: Prevalence of non-alcoholic fatty liver and characteristics in overweight adolescents in the general population
verfasst von: Armin Imhof
Wolfgang Kratzer
Bernhard Boehm
Katrin Meitinger
Gerlinde Trischler
Gerald Steinbach
Isolde Piechotowski
Wolfgang Koenig
Publikationsdatum: 01.12.2007
Verlag: Springer Netherlands
Erschienen in: European Journal of Epidemiology / Ausgabe 12/2007
Print ISSN: 0393-2990
Elektronische ISSN: 1573-7284
DOI: https://doi.org/10.1007/s10654-007-9181-7

Springer Medizin

Abstract

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