This article is more than 5 years old. Information may no longer be current.

Higher liver fat in children raises cardio-metabolic risk regardless of BMI

Researchers determined that higher liver fat content independent of BMI correlated with an adverse cardio-metabolic risk profile among children.

“Due to the high rates of childhood overweight and obesity, non-alcoholic fatty liver disease has also become the most common chronic liver disease in children in the developed world,” Madelon L. Geurtsen, from the University Medical Center Rotterdam in the Netherlands, and colleagues wrote. “We also observed that the associations of liver fat with cardio-metabolic risk factors in childhood were independent of BMI, and present among both normal weight and overweight children, with stronger effect estimates among overweight children.”

The study comprised 3,170 children who attended an MRI subgroup study at age 10 years and presented with at least one cardio-metabolic outcome.

Compared with children with less than 2% liver fat, those with 5% liver fat or more had the strongest associations with cardio-metabolic risk factors including systolic blood pressure (OR = 0.76; 95% CI, 0.55-0.97), diastolic blood pressure (OR = 0.41; 95% CI, 0.19-0.62), Homeostatic Model Assessment of Insulin Resistance (OR = 0.41; 95% CI, 0.16-0.67), total cholesterol (OR = 0.51; 95% CI, 1.24-3.67), triglycerides (OR = 0.81; 95% CI, 0.56-1.07), and C-reactive protein (OR = 1.06; 95% CI, 0.81-1.31).

The correlation between liver fat and NAFLD with cardio-metabolic risk factors remained after additional adjustment for childhood BMI.

Higher liver fat also correlated with higher risks for cardio-metabolic clustering from 2% liver fat fraction and upward (P < .05). Children with 5% liver fat or more had the highest odds for cardio-metabolic clustering (OR = 24.43; 95% CI, 12.25-48.6) compared with those with less than 2% liver fat. Additionally, high visceral fat mass had the strongest association for liver fat (OR = 27.8; 95% CI, 14.5-53.3).

“These findings suggest that diagnosing nonalcoholic fatty liver disease in children might need a lower threshold than 5% liver fat,” the researchers concluded.” Current conventional ultrasounds cannot measure this low liver fat percentage, but future improvements in resolution of ultrasound techniques may enable detection of lower fat percentages.” – by Talitha Bennett

Disclosures: Geurtsen reports financial support for the study from the Erasmus MC, University Medical Center, Rotterdam, Erasmus University Rotterdam, Netherlands Organization for Health Research and Development (ZonMw), Netherlands Organisation for Scientific Research (NWO), Ministry of Health, Welfare and Sport and Ministry of Youth and Families. Please see the full study for all other authors' relevant financial disclosures.