Predicting hepatic steatosis and liver fat content in obese children based on biochemical parameters and anthropometry

Hx, Zhang; Xu, Xiao; Fu, Jing; Lai, Chen; Xf, Chen

doi:10.1111/ijpo.232

Cited by 12 publications

(13 citation statements)

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“…Anthropometric indices such as WC, W/H, and WHtR have been proposed for metabolic syndrome prediction in obese children [22][23][24] . The results of previous studies showed waist circumference, waisthip ratio, and WHtR in combination with other routinely available variables such as the homeostasis model assessment of insulin resistance (HOMA-IR), reduced physical activity, and alanine aminotransferase (ALT) might be used to identify obese children at the highest risk of NAFLD 12,13,23 . According to the results of Lin et al 13 , waist circumference is important in predicting NAFLD in obese children, but should be assessed together with glucose changes in an oral glucose-tolerance test.…”

Section: Discussionmentioning

confidence: 99%

“…The results of studies to date have emphasized that some anthropometric indices can be used to predict NAFLD. However, this issue is still controversial [12][13][14] . In this study, we aimed to assess the role of anthropometric parameters in the prediction of NAFLD and identify cutoff values for useful anthropometric indices in the prediction of NAFLD in obese children.…”

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confidence: 99%

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Waist to height ratio: a simple screening tool for nonalcoholic fatty liver disease in obese children

et al. 2016

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Simple predictors are needed for the screening of nonalcoholic fatty liver disease (NAFLD) in obese children. We aimed to assess the role of anthropometric parameters in the prediction of NAFLD. Three hundred and thirty two obese children (152 male, 180 female) aged 4.6-17.0 years were included in this study. Weight, height, waist (WC), and hip circumference were measured. Body mass index (BMI), waist-hip-ratio (WHR), and waist-height-ratio (WHtR) were calculated. Obesity was defined as BMI for age and sex ≥ 95th percentile. NAFLD was diagnosed using ultrasonography (US). NAFLD was present in 60.8% of obese children. Fatty liver prevalence differed significantly by gender and puberty (55.0% of girls vs 67.7% of boys, and 28.7% in prepubertal vs 71.3% in pubertal children; p < 0.05). Significantly higher BMI, BMI standard deviation score (SDS), WC, and WHtR were found in obese children with NAFLD compared to obese children without NAFLD (p < 0.05). Only WHtR was found to be an independent predictor for NAFLD in a logistic regression analysis (p < 0.001, B:1.096, 95% CI 1.047-1.148). Fatty liver is common among obese children, particularly in obese boys. WHtR is a simple and easy index for predicting of NAFLD in obese children and can be used for mass screening in public health.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Waist to height ratio: a simple screening tool for nonalcoholic fatty liver disease in obese children

et al. 2016

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“…With these scores, early detection of NAFLD is possible, keeping in mind their moderate sensitivity and specificity [ 11 ]. In children, prediction by liver fat estimations tends to be more precise, possibly accounting for a stronger linkage between adiposity and metabolic disorder as compared to post-menopausal cohorts [ 12 , 13 ]. As a general limitation, it is noteworthy that all available indices have been validated against ultrasound sonography, which itself does not precisely reflect NAFLD.…”

Section: Introductionmentioning

confidence: 99%

Liver Fat Scores Moderately Reflect Interventional Changes in Liver Fat Content by a Low-Fat Diet but Not by a Low-Carb Diet

et al. 2018

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Background: Non-alcoholic fatty liver disease (NAFLD) is a common metabolic disorder all over the world, mainly being associated with a sedentary lifestyle, adiposity, and nutrient imbalance. The increasing prevalence of NAFLD accommodates similar developments for type 2 diabetes and diabetes-related comorbidities and complications. Therefore, early detection of NAFLD is an utmost necessity. Potentially helpful tools for the prediction of NAFLD are liver fat indices. The fatty liver index (FLI) and the NAFLD-liver fat score (NAFLD-LFS) have been recently introduced for this aim. However, both indices have been shown to correlate with liver fat status, but there is neither sufficient data on the longitudinal representation of liver fat change, nor proof of a diet-independent correlation between actual liver fat change and change of index values. While few data sets on low-fat diets have been published recently, low-carb diets have not been yet assessed in this context. Aim: We aim to provide such data from a highly effective short-term intervention to reduce liver fat, comparing a low-fat and a low-carb diet in subjects with prediabetes. Methods: Anthropometric measurements, magnetic resonance (MR)-based intrahepatic lipid (IHL) content, and several serum markers for liver damage have been collected in 140 subjects, completing the diet phase in this trial. Area-under-the-responder-operator-curves (AUROC) calculations as well as cross-sectional and longitudinal Spearman correlations were used. Results: Both FLI and NAFLD-LFS predict liver fat with moderate accuracy at baseline (AUROC 0.775–0.786). These results are supported by correlation analyses. Changes in liver fat, achieved by the dietary intervention, correlate moderately with changes in FLI and NAFLD-LFS in the low-fat diet, but not in the low-carb diet. A correlation analysis between change of actual IHL content and change of single elements of the liver fat indices revealed diet-specific moderate to strong correlations between ΔIHL and changes of measures of obesity, ΔTG, and ΔALT (all low-fat, only) and between ΔIHL and ΔGGT (low-carb, only). With exception for a stronger decrease of triglycerides (TG) levels in the low-carb diet, there is no statistically significant difference in the effect of the diets on anthropometric or serum-based score parameters. Conclusion: While liver fat indices have proved useful in the early detection of NAFLD and may serve as a cost-saving substitute for expensive MR measurements in the cross-sectional evaluation of liver status, their capability to represent interventional changes of liver fat content appears to be diet-specific and lacks accuracy. Liver fat reduction by low-fat diets can be monitored with moderate precision, while low-carb diets require different measuring techniques to demonstrate the same dietary effect.

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“…Ultrasound is a popular screening tool for patients with an abnormal liver function test, which varies without consistent values or upper normal thresholds in children. Body Mass Index (BMI) and waist circumference are anthropometric measurements widely used to evaluate the effects of obesity on metabovascular risk factors and NAFLD [ 7 ]. Contrary to waist circumference and BMI, the values of waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) have the advantages without requiring population-specific reference tables or changes in body composition with growth and development.…”

Section: Introductionmentioning

confidence: 99%

Waist-to-height ratio is a useful index for nonalcoholic fatty liver disease in children and adolescents: a secondary data analysis

Lin

Guo

et al. 2017

BMC Public Health

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BackgroundNonalcoholic fatty liver disease (NAFLD) is a global problem and pediatric obesity has risen dramatically. Early NAFLD might progress to nonalcoholic steatohepatitis (NASH) or liver cirrhosis and significantly increase liver disease-related mortality. We looked for NAFLD predictors in children and adolescents.MethodsThis community-based, cross-sectional study ran from December 2012 to September 2013 in southwestern Taiwan. Children <10 and >19 years old, with detected hepatic diseases, or who drank alcohol were excluded. The diagnosis of NAFLD was based on ultrasound: age, sex, anthropometric measurements, and laboratory data were evaluated for associated risks by using logistic regression analysis. Receiver operating characteristic (ROC) curves were used to determine cutoff values.ResultsWe enrolled one thousand, two hundred and ten children (594 males; 616 females; mean age: 15.5 ± 2.8 years). Age, anthropometric measurements, and laboratory data were significantly higher in children with NAFLD. The association between NAFLD and the waist-to-height ratio (WHtR) was significant (adjusted odds ratio: 2.6; 95% confidence interval: 1.909-3.549; P < 0.001). It indicated highly suspicion of NAFLD (sensitivity: 70.1%; specificity 76.9%) when the WHtR for children and adolescents is above the cutoff value of 0.469.ConclusionsThe WHtR might be a powerful index of the severity of pediatric NAFLD.

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Predicting hepatic steatosis and liver fat content in obese children based on biochemical parameters and anthropometry

Abstract: The liver fat score and liver fat equation, consisting of routinely available variables, may help paediatricians to accurately determine hepatic steatosis and LFC in clinical practice, but external validation is needed before it can be employed for this purpose.

Cited by 12 publications

References 31 publications

Waist to height ratio: a simple screening tool for nonalcoholic fatty liver disease in obese children

Waist to height ratio: a simple screening tool for nonalcoholic fatty liver disease in obese children

Liver Fat Scores Moderately Reflect Interventional Changes in Liver Fat Content by a Low-Fat Diet but Not by a Low-Carb Diet

Waist-to-height ratio is a useful index for nonalcoholic fatty liver disease in children and adolescents: a secondary data analysis

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