Dyslipidemia and hyperinsulinemia in children and adolescents with chronic liver disease: relation to disease severity

Abstract

Lipid metabolism is profoundly disturbed in chronic liver diseases (CLD). Moreover, patients with cirrhosis displayed chronically elevated serum insulin (SI) concentrations. The aim of this work was to assess fasting lipid profile (FLP) and SI levels among Egyptian patients with CLD and their relation to severity of liver disease. A total of 40 Egyptian children with CLD were compared with 30 age-, sex-, and pubertal stage-matched controls. All subjects were subjected to history and auxological assessment; their FLP, fasting blood glucose (FBG) and SI were measured; and their fasting glucose/insulin (G/I) ratios were calculated. Total cholesterol (TC, p=0.006), triglycerides (TG, p=0.03), low density lipoproteins (LDL, p=0.034), and SI (p<0.001) were significantly higher while high density lipoproteins (HDL, p<0.001) and G/I ratio (p<0.001) were significantly lower as serum albumin decreased; these were also lower among cases with a progressive decrease going from child A to C. Of the 40 studied cases, eight (20%) had hypercholesterolemia, 13 (32.5%) had hypertriglyceridemia, 17 (42.5%) had low HDL and 9 (22.5%) had high LDL, 32 (80%) had hyperinsulinemia (HI), and 11 (27.5%) had insulin resistance (IR). Dyslipidemia and HI were frequent findings in patients with CLD, which worsened with increased severity of CLD.