Background

Liver dysfunction can occur decades after long-term obesity-related metabolic abnormalities. In this study we compared children from two cohorts (i.e., the SAFARI cohort of Mexican Americans from US [SC, n=670, females 49.3%] and a Mexico City-based cohort from Hospital General de Mexico [MC, n= 257, females 49.8%]) for pediatric metabolic index (PMI) association with liver dysfunction measured with the AST/ALT index (AAI).

Methods

We collected data on anthropometric, lipid, and liver enzyme profiles to calculate PMI and AAI.Student’s t-test and multilevel analysis for mixed models were performed with STATA v15.

Results

Both groups (SC vs MC, respectively) showed similar BMI (SD) [22.7 (6.5) vs 22.3 (4.7), p=0.26] and waist circumference [76.4 (18) vs 75.6 (12.6), p=0.45]. Subjects from SC were older [11.5 (3.5) vs 10.3 (1.4), p<0.01], had higher systolic blood pressure [104 (10) vs 97 (12), p<0.01] and AAI [1.58 (1.48) vs 1.39 (0.48), p=0.007]. MC participants have low HDL-C [45.8 (11) vs (41.9 (11), p<0.01], high triglycerides [75 (40) vs 126 (71), p<0.01] and high PMI [1.1 (0.85) vs 2.0 (1.5), p<0.01].In the multilevel analysis, BMI (b=-0.03, p=0.01) and country of origin (b=0.22, p=0.035) were found to be the best predictors for AAI. However, PMI did not show any effect (p=0.52) on liver abnormalities.

Conclusions

In conclusion, given the expected similar genetic background, potential environmental differences between the countries seem to contribute to the observed differential obesity-related liver dysfunction profiles between these two cohorts of children. Future studies are needed to explore the mechanisms underlying these findings.