Association between fatty liver disease markers and physical activity and sedentary time in children and adolescents with obesity

Abstract

Purpose: To compare patterns of sedentary (SED) time (more sedentary, SED+ vs less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs less active, MVPA-) and combinations of behaviors (SED-/MVPA+, SED-/MVPA-, SED+/MVPA+, SED+/MVPA-) regarding nonalcoholic fatty liver diseases (NAFLD) markers. Methods: This cross-sectional study included 134 subjects (13.4±2.2yrs, body mass index (BMI) 98.9±0.7 percentile, 48.5% females) who underwent 24h/7day accelerometry, anthropometric and biochemical markers (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), AST/ALT and Fatty Liver Index (FLI)). A subgroup of 39 patients underwent magnetic resonance imaging-liver fat content (MRI-LFC).Results: Hepatic health was better in SED- [lower ALT, GGT and MRI-LFC (p<0.05), higher AST/ALT (p<0.01)] vs SED+ and in MVPA+ [lower ALT (p<0.05) and FLI (p=0.001), higher AST/ALT (p<0.01)] vs MVPA- groups after adjustment for age, gender and Tanner stages. SED-/MVPA+ group had the best hepatic health. SED-/MVPA- group had lower ALT and GGT and higher AST/ALT (p<0.05) in comparison with SED+/MVPA+ group independently of BMI. SED time was positively associated with biochemical (high ALT, low AST/ALT ratio) and imaging (high MRI-LFC) markers independently of MVPA. MVPA time was associated with biochemical markers (low ALT, FLI, high AST/ALT) but these associations were no longer significant after adjustment for SED time, except for FLI (p<0.001). Conclusions: Lower SED time is associated with better hepatic health independently of MVPA. Reducing SED time might be a first step in the management of pediatric obesity NAFLD when increasing MVPA is not possible.

Circulating leukocyte cell-derived chemotaxin 2 and fibroblast growth factor 21 are negatively associated with cardiorespiratory fitness in healthy volunteers

“…Additionally, the study participants were free from chronic disease; thus, future studies are needed to test our identified associations in clinical populations such as type 2 diabetes and NAFLD. Finally, whilst this study examined whether activity behaviours were independently associated with hepatokines, future studies should determine the interactive effects of sedentary time and physical activity (Julian et al, 2022).…”