Background

Non-alcoholic fatty liver disease (NAFLD) has been recognized as a consequence of obesity and insulin resistance and several studies have reported its association with Type 2 DM and metabolic syndrome. However, the association of NAFLD with dyslipidemia is not adequately studied in children. This study is to examine the association of NAFLD and blood lipids in ethnic minority children with obesity

Methods

This is a retrospective chart review of 376 patients aged 3-18 years, mostly Hispanics and African Americans who were seen in our pediatric weight management clinic. Initial visit data on anthropometric measurements, fasting blood lipids, insulin and glucose, and alanine transaminase (ALT) as well as liver ultrasound and biopsy, were collected.Insulin resistance was calculated based on the Homeostatic Model Assessment of IR (HOMA-IR) score. The prevalence of NAFLD (defined by ALT > 40 U/L and/or liver US or biopsy) was compared between sex and race/ethnic groups using Chi square test. Pearson correlation analysis was used to identify the metabolic variables that significantly associated with ALT. These variables were included in a linear regression model as independent variables along with sex and ethnicity variables.

Results

Participants were 50.5% females, 58.6% Hispanics, with mean age of 11.6 years (SD 3.4 years). The prevalence of NAFLD was significantly higher in boys (31%) than girls (18%), and in Hispanics (39%) than African Americans (11%). Using univariate analysis, ALT significantly correlated with all blood lipid variables, insulin, glucose and HOMA –IR. However, regression analysis results showed the association of NAFLD and HOMA-IR was no longer significant when the triglycerides (TG) was included in the model. The only significant association was for TG (B coefficient = 0.23 at p < 0.0001).

Conclusions

In obese children, NAFLD is more prevalent in males and Hispanics, and TG, not IR, is significantly associated with NAFLD.Further studies are needed to confirm our findings