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Published on: March 24, 2023
Dyslipidemia is associated with pediatric nonalcoholic fatty liver disease
Shima Dowla1, Stella Aslibekyan2, Amy Goss3
1Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA; School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Insights
Childhood obesity is driving nonalcoholic fatty liver disease (NAFLD). This study found cardiometabolic issues, particularly dyslipidemia, are common in pediatric NAFLD and vary by race/ethnicity, with triglycerides and non-HDL cholesterol playing a key role.
Area of Science:
- Pediatric Hepatology
- Cardiovascular Health in Children
- Metabolic Disorders
Background:
- Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in children, often linked to rising obesity rates.
- The underlying factors contributing to the development of pediatric NAFLD are not fully understood.
Purpose of the Study:
- To investigate the metabolic profiles of children diagnosed with NAFLD.
- To examine how these metabolic characteristics differ across various racial and ethnic groups.
- To determine the association between dyslipidemia and the presence of NAFLD in pediatric patients.
Main Methods:
- A retrospective analysis of medical records was performed for 309 children diagnosed with NAFLD at a university hospital.
- Data collected included patient demographics, anthropometrics, diagnoses (hypertension, diabetes), and lipid profiles.
Main Results:
- Hispanic children were diagnosed with NAFLD at a younger age and lower BMI compared to white and black children.
- High prevalence of cardiometabolic derangements was observed, including hypertension (41%), diabetes (14%), and dyslipidemia (elevated non-HDL-C 58%, elevated TG 77%).
- White children exhibited higher levels of elevated non-high-density lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol, and triglycerides (TG) compared to other racial/ethnic groups. Serum TG and non-HDL-C levels correlated with alanine aminotransferase, indicating a potential role in liver injury.
Conclusions:
- Cardiometabolic abnormalities, especially dyslipidemia, are frequent in children with NAFLD and show ethnic variations.
- Elevated serum triglycerides and non-HDL-C may be significant factors in the pathophysiology of pediatric NAFLD.
Background:
With the increasing prevalence of childhood obesity, nonalcoholic fatty liver disease (NAFLD) has emerged as the most common cause of pediatric chronic liver disorder. Factors underlying the pathophysiology of NAFLD remain poorly defined.
Objective:
This study aimed to describe the metabolic characteristics of children with NAFLD differing in race/ethnicity and to test associations between dyslipidemia and NAFLD.
Methods:
A retrospective chart review was conducted at a tertiary referral university hospital among 309 children with a diagnosis of NAFLD.
Results:
Participants (mean age 12.5 ± 3.4 years) were 64% male, 63% white, 23% Hispanic, and 14% black. Hispanic children were diagnosed with NAFLD at a significantly younger age (10.6 ± 3.1 years, P < .0001) and lower body mass index (31.5 ± 6.8 kg/m2, P < .0001) than their white and black counterparts. For the entire cohort, prevalence of systolic hypertension was 41%, diabetes 14%, elevated cholesterol 42%, elevated non-high-density lipoprotein cholesterol (non-HDL-C) 58%, elevated low-density lipoprotein cholesterol 36%, elevated triglycerides (TG) 88%, and low high-density lipoprotein cholesterol 77%. Whites had elevated non-HDL-C, low-density lipoprotein cholesterol, and TG compared to blacks or Hispanics. Serum TG and non-HDL-C were significantly correlated to alanine aminotransferase (r = 0.18, P = .01; r = 0.16, P = .02), respectively, and persisted after adjusting for age and body mass index.
Conclusion:
Cardiometabolic derangements, especially dyslipidemia, are highly prevalent in children with NAFLD and differ based on race/ethnicity. Serum TG and non-HDL-C may play an important role in the pathophysiology of pediatric NAFLD.
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