Carotid intima-media thickness and flow-mediated dilation in obese children with non-alcoholic fatty liver disease

Torun, Emel; Aydın, Sinem; Gökçe, Selim; Özgen, İlker Tolga; Dönmez, T.; Cesur, Yaşar

doi:10.5152/tjg.2014.5552

Cited by 12 publications

(12 citation statements)

References 33 publications

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“…Obesity and overweight are both components of metabolic syndrome, which is an important risk factor for atherosclerosis. An increased BMI 33 34 , visceral fat accumulation 22 and childhood obesity 35 36 are also significantly associated with greater CIMT. However, the relationship between BMI and ALD combined with H. pylori infection has not been determined.…”

Section: Discussionmentioning

confidence: 99%

The Correlation and Risk Factors between Carotid Intima-Media Thickening and Alcoholic Liver Disease Coupled with Helicobacter pylori Infection

Wang

Jia

et al. 2017

Sci Rep

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The aim of this study was to explore the associations and differences in influencing factors between alcoholic liver disease (ALD) coupled with Helicobacter pylori infection and atherosclerosis and to determine whether there is a “double hit phenomenon” in atherosclerosis patients with ALD and H. pylori infections. Included cases (n = 160) were categorized into 4 groups: 41 cases of ALD coupled with H. pylori infections (group A), 35 cases of H. pylori infections without ALD (group B), 37 cases of ALD without H. pylori infections (group C), and 47 normal control cases (group D). CIMT was significantly greater in group A than in groups B and D (P = 0.005 and P = 0.001, respectively). The GLM univariate analysis found that CIMT was significantly greater in group A than in groups B, C and D (P = 0.018, P = 0.001 and P = 0.009, respectively). We found that BMI and ALT, AST and ApoB levels were independent predictors of CIMT (P = 0.000, P = 0.000, P = 0.012 and P = 0.014, respectively). ALD coupled with H. pylori infection may result in significant CIMT thickening, but H. pylori infection without ALD and ALD without H. pylori infection does not, suggesting that a “double hit phenomenon” occurs. Additionally, BMI, and ALT, AST and ApoB levels were independent risk factors for increased CIMT.

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Section: Discussionmentioning

confidence: 99%

The Correlation and Risk Factors between Carotid Intima-Media Thickening and Alcoholic Liver Disease Coupled with Helicobacter pylori Infection

Wang

Jia

et al. 2017

Sci Rep

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“…Other authors have also found similar correlations of elevated cIMT with NAFLD ( 18 , 20 – 22 , 25 – 28 , 31 , 33 , 34 ), and have linked increased severity of steatosis to even higher cIMT values ( 18 , 25 ), and lower FMD values ( 21 ). The inclusion of hepatic steatosis on ultrasound may improve the cIMT predictability of cardiac disease as compared to metabolic syndrome alone ( 28 ).…”

Section: Methodsmentioning

confidence: 53%

“…One study also used magnetic resonance imaging (MRI) findings as well to identify patients with steatosis ( 19 ). In some papers, a grading system was used to identify the level of steatosis or changes on liver ultrasound ( 18 , 21 – 23 , 26 , 28 , 29 , 33 ). Many of the papers either used BMI percentile ( 14 , 17 – 19 , 21 – 23 , 25 , 26 , 28 , 32 , 38 , 39 ) or a fixed BMI >28–30 kg/m 2 to define obesity ( 27 , 29 – 31 , 33 ).…”

Section: Methodsmentioning

confidence: 99%

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Is There an Association of Vascular Disease and Atherosclerosis in Children and Adolescents With Obesity and Non-alcoholic Fatty Liver Disease?

Karjoo

2018

Front. Pediatr.

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Carotid intima media thickness (cIMT) and brachial flow-mediated dilation (FMD) evaluated by ultrasound are non-invasive markers of atherosclerosis. Increased cIMT in adults has been correlated to early vascular damage. Several studies show similar correlations of elevated cIMT in children with obesity, hyperlipidemia, and metabolic syndrome. Additionally, several articles have correlated non-alcoholic fatty liver disease (NAFLD) with elevated cIMT, indicating early atherosclerosis. It is alarming that these vascular changes may be seen in children as young as 10 years of age. Children with NAFLD may also have an increased pulse wave velocity that correlates to increased arterial stiffness and increased left ventricular dimension, mass, and diastolic dysfunction. These articles are persuasive, indicating a correlation of Pediatric NAFLD and early vascular disease. However, study limitations include the use of elevated alanine aminotransferase (ALT) and echogenic changes on ultrasound that may have low accuracy to identify NAFLD. Ultrasound has low sensitivities and specificities for detection of NAFLD and therefore is not recommended for diagnosis. In comparison, studies that used liver biopsy or proton magnetic resonance spectroscopy to identify NAFLD did not find a correlation with elevated cIMT or reduction in FMD. Due to these conflicting findings, more studies looking at cIMT and FMD changes in children with NAFLD are needed with more accurate diagnostic methods for steatosis to identify if there truly is a correlation of increased liver steatosis to early atherosclerosis.

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“…In the literature, pathology studies have revealed that atherosclerosis is an early-onset process starting from childhood, with fatty streaks found in the aorta and the coronary and carotid arteries of children ( 15 - 17 ). Early evaluation of vascular impairment is therefore crucial to prevent future vascular events because subclinical atherosclerosis can be reversed if diagnosis and intervention are conducted early.…”

Section: Discussionmentioning

confidence: 99%

Association between the corrected QT interval, carotid artery intima-media thickness, and hepatic steatosis in obese children

Daar

Serin²,

Ede³

et al. 2015

Anatol J Cardiol

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Objective:Childhood obesity is related to subclinical atherosclerosis. Carotid intima-media thickness (CIMT) and hepatosteatosis are parameters that reflect subclinical atherosclerosis and are shown to be associated with obesity. However, their relation with the corrected QT interval (QTc) has not been thoroughly studied in children. Here, we aimed to research the relation between QTc, hepatic steatosis, and CIMT among obese children.Methods:Fifty-three obese and 53 age- and sex-matched non-obese children aged 6–16 years were included in this prospective cross-sectional study. The QTc of each subject was accordingly obtained from lead II on a 12-lead resting electrocardiogram. Thus, CIMT measurement and abdominal ultrasonographic examination were performed. The data for obese and non-obese children were analyzed and compared.Result:The age and gender distribution of the subjects were statistically similar. The CIMT value of the obese group was higher than that of the non-obese group (p<0.001). The obese group had a higher frequency of hepatosteatosis at grade 1 or 2 than the non-obese group (p<0.001). The QTc values were also found to be more prolonged in the obese group than in the other group (p<0.001). With Student’s t-test and Mann-Whitey U test accordingly.Conclusion:We demonstrated that obese children had higher CIMT and QTc values as well as more frequent hepatosteatosis, and that the presence of hepatosteatosis or increased CIMT had an association with prolonged QTc values in obese children. Therefore, with the aim of detecting cardiovascular effects of obesity, it may be beneficial to perform the measurements of QTc in the presence of hepatosteatosis and/or increased CIMT among obese children.

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Carotid intima-media thickness and flow-mediated dilation in obese children with non-alcoholic fatty liver disease

Cited by 12 publications

References 33 publications

The Correlation and Risk Factors between Carotid Intima-Media Thickening and Alcoholic Liver Disease Coupled with Helicobacter pylori Infection

The Correlation and Risk Factors between Carotid Intima-Media Thickening and Alcoholic Liver Disease Coupled with Helicobacter pylori Infection

Is There an Association of Vascular Disease and Atherosclerosis in Children and Adolescents With Obesity and Non-alcoholic Fatty Liver Disease?

Association between the corrected QT interval, carotid artery intima-media thickness, and hepatic steatosis in obese children

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