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Title: Fatty Liver Disease May Raise Heart Disease Risk in Overweight and Obese Children
URL: http://www.pslgroup.com/dg/224AD6.htm
Doctor's Guide
June 30, 2008

DALLAS -- June 30, 2008 -- A fatty liver disease that is not well known in overweight and obese children may be a precursor of cardiovascular disease, researchers reported in Circulation: Journal of the American Heart Association.

Researchers performed a case-controlled study of 150 overweight children with biopsy-proven non-alcoholic fatty liver disease (NAFLD) and 150 overweight children without NAFLD. Participants were well matched in age, sex, and severity of obesity. More than half of the children in each group were in the 99th percentile for body mass index (BMI).

The overweight children with NAFLD had significant cardiovascular risk including higher levels of fasting glucose, insulin, total cholesterol, low-density lipoprotein, triglycerides, and higher systolic and diastolic blood pressure than the control group. The children with NAFLD also had significantly lower levels of high-density lipoprotein than the control group.

Researchers found the distribution of the disease by race and ethnicity was also significantly different, with more Hispanic and Asian children in the fatty liver group and more white and black children in the control group. They also found that children with metabolic syndrome were 5 times more likely to have NAFLD as overweight and obese children without metabolic syndrome.

"Our results demonstrate that obese children and adolescents with a definitive diagnosis of NAFLD have a more severe cardiovascular risk profile than their age, sex, and BMI-matched peers," said lead author of the study, Jeffrey Schwimmer, MD, University of California, San Diego, California. "These collective data illustrate that fat accumulation in the liver may play a more important role than obesity itself in determining the risk for 'weight-related' metabolic comorbidities. Thus, in children and adolescents, NAFLD may serve as a marker to stratify the cardiovascular risk of overweight and obese patients."

"Overweight children aged 8 or older and especially those with symptoms of metabolic syndrome should be screened for NAFLD," Dr. Schwimmer said. "I think many parents have not ever heard of NAFLD, and many physicians are not aware of its prevalence and severity in children. Identification of NAFLD in a child should prompt counselling that addresses nutrition, physical activity, and avoidance of smoking."


SOURCE: American Heart Association

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