Abstract | BACKGROUND & AIMS: METHODS: We recruited a cohort of 599 Caucasian children/adolescents with biopsy-proven NAFLD, and 118 children/adolescents without NAFLD, who were selected to be similar for age, sex, body mass index and waist circumference to those with NAFLD. The diagnosis of prediabetes and diabetes was based on either hemoglobin A1c, fasting plasma glucose or 2 h post-load glucose concentrations. RESULTS: Children/adolescents with NAFLD had a significantly higher prevalence of abnormal glucose tolerance ( prediabetes or diabetes) than those without NAFLD (20.6% vs. 11%, p = 0.02). In particular, 124 (20.6%) children/adolescents with NAFLD had abnormal glucose tolerance, with 19.8% (n = 119) satisfying the diagnostic criteria for prediabetes and 0.8% (n = 5) satisfying the criteria for diabetes. The combined presence of prediabetes and diabetes was associated with a nearly 2.2-fold increased risk of non- alcoholic steatohepatitis (NASH; unadjustedodds ratio 2.19; 95% CI 1.47-3.29; p <0.001). However, this association was attenuated (but remained significant) after adjustment for age, sex, waist circumference (adjustedodds ratio 1.69, 95% CI 1.06-2.69, p = 0.032), and the PNPLA3 rs738409 polymorphism. Both this PNPLA3 polymorphism and waist circumference were strongly associated with NASH. CONCLUSIONS: Abnormal glucose tolerance (especially prediabetes) is highly prevalent among children/adolescents with biopsy-proven NAFLD. These children also have a higher risk of NASH, though central adiposity is the factor that is most strongly associated with NASH. LAY SUMMARY:
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Authors | Valerio Nobili, Alessandro Mantovani, Stefano Cianfarani, Anna Alisi, Antonella Mosca, Maria Rita Sartorelli, Claudio Maffeis, Rohit Loomba, Christopher D Byrne, Giovanni Targher |
Journal | Journal of hepatology
(J Hepatol)
Vol. 71
Issue 4
Pg. 802-810
(10 2019)
ISSN: 1600-0641 [Electronic] Netherlands |
PMID | 31279904
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2019 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. |
Chemical References |
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Topics |
- Adolescent
- Biopsy
(methods, statistics & numerical data)
- Body Mass Index
- Child
- Cross-Sectional Studies
- Diabetes Mellitus, Type 2
(blood, diagnosis, epidemiology)
- Female
- Glucose Intolerance
(blood, diagnosis, epidemiology)
- Glycated Hemoglobin
(analysis)
- Humans
- Liver
(pathology)
- Male
- Non-alcoholic Fatty Liver Disease
(diagnosis, epidemiology)
- Obesity, Abdominal
(diagnosis, epidemiology)
- Prediabetic State
(blood, diagnosis, epidemiology)
- Prevalence
- Risk Factors
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