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The relationship between fatty liver and hyperinsulinemia in obese Japanese children
T Kawasaki1, N Hashimoto, T Kikuchi
1Department of Pediatrics, Niigata University School of Medicine, Japan.
Insights
Hyperinsulinemia significantly contributes to fatty liver in obese children, more so than body measurements or blood markers. This finding highlights the crucial role of insulin in pediatric obesity-related liver disease.
Area of Science:
- Pediatric Endocrinology
- Hepatology
- Metabolic Syndrome
Background:
- Obesity in children is linked to insulin resistance and fatty liver disease.
- Previous studies suggest a connection between hyperinsulinemia and fatty liver in adults.
- The role of hyperinsulinemia in pediatric fatty liver remains to be fully elucidated.
Purpose of the Study:
- To investigate the significance of hyperinsulinemia in obese children diagnosed with fatty liver.
- To determine the contribution of hyperinsulinemia to fatty liver development in pediatric obesity.
Main Methods:
- A cohort of 228 obese children (ages 6-15) in Niigata Prefecture, Japan, was studied.
- Fatty liver was assessed by serum glutamic pyruvic transaminase (GPT) levels.
- Regression analyses evaluated the impact of obesity metrics, lipids, glucose, and insulin on GPT.
Main Results:
- The incidence of fatty liver was 24.1% among the participants.
- Percent obesity, Rohrer index, skinfold thickness, total cholesterol, triglycerides, blood glucose, and insulin all correlated with GPT.
- Hyperinsulinemia (IRI) alone explained 24.2% of GPT variance, with total cholesterol and percent obesity further improving predictive models.
Conclusions:
- Hyperinsulinemia is a key factor in the development of fatty liver in obese children.
- Insulin's role appears more significant than anthropometric data, blood glucose, or serum lipids.
- Early identification and management of hyperinsulinemia may be crucial for preventing fatty liver in pediatric obesity.
Background:
Previous reports have revealed that fatty liver involving obesity is closely related to insulin resistance or hyperinsulinemia in adulthood. This study investigates the importance of hyperinsulinemia in obese children with fatty liver.
Methods:
The subjects were 228 obese children 6 to 15 years old in Niigata Prefecture, Japan. The serum level of glutamic pyruvic transaminase (GPT) was evaluated as an indicator of fatty liver. The effects of their percent obesity (percent over ideal body weight), Rohrer index (g/cm3), skinfold thickness, percent body fat measured by bioelectrical impedance analysis, total cholesterol (TC), high-density lipoprotein cholesterol, triglyceride (TG), blood glucose, and immuno-reactive insulin (IRI) on GPT were evaluated using regression analyses.
Results:
The incidence of fatty liver (GPT over 35 IU/I) was 24.1% in this study. In simple regression analyses, percent obesity, Rohrer index, skinfold thickness, TC, TG, blood glucose, and IRI correlated positively with GPT (p < 0.05). In stepwise regression analysis including these seven variables, the predictive equation for GPT as a function of IRI alone accounted for 24.2% of the total variance of GPT. The addition of TC alone, and TC and percent obesity together increased the coefficients of determination to 28.4% and 29.9%, respectively. Rohrer index, skinfold thickness, Tg, and blood glucose were not taken as related variables with GPT.
Conclusion:
Hyperinsulinemia is an important contributor to the development of fatty liver, apparently more than anthropometric data, blood glucose, or serum lipids in childhood obesity.