Abstract
Background: Adolescent non-alcoholic fatty liver disease (NAFLD) is associated with cardiometabolic risk factors. The association between adolescent NAFLD and a wide range of metabolic biomarkers is unclear. We have attempted to determine the differences in metabolic profile of adolescents with and without markers of NAFLD. Methods: We performed cross-sectional analyses in a sample of 3,048 participants from the Avon Longitudinal Study of Parents and Children at age 17. We used three indicators of NAFLD: ALT >40 U/l; AST >40 U/l and ultrasound scan-assessed steatosis. Associations between each measure of NAFLD and 154 metabolic traits, assessed by Nuclear Magnetic Resonance, were analyzed by multivariable linear regression, adjusting for age, sex and BMI. Results: All three indicators of NAFLD were associated with ~0.5 standard deviation (SD) greater concentrations of all extremely large to small very low-density lipoproteins (VLDL) measures. ALT >40U/l was associated with ~0.5SD greater concentrations of very small VLDLs, intermediate-density lipoproteins and low-density lipoproteins. Concentrations of most cholesterols, including remnant cholesterol, all triglycerides and monounsaturated fatty acids, in addition to glycoprotein acetyls (inflammatory marker), were also higher in participants with NAFLD. Conclusions: We have identified differing metabolic profiles between adolescents with and without indicators of NAFLD. These results provide the foundations for future research to determine whether these differences persist and result in adverse future cardiometabolic health.
Highlights
Adolescent non-alcoholic fatty liver disease (NAFLD) is associated with cardiometabolic risk factors
Using a population of adolescents from the Avon Longitudinal Study of Parents and Children (ALSPAC), we recently showed that, even in unselected adolescents, ultrasound scandetermined hepatic steatosis is associated with higher levels of fasting triglycerides, glucose and insulin, and reduced levels of high density lipoproteins (HDLs) cholesterol (HDLc), independent of body mass index (BMI) or total body fat mass (TBFM)[12]
At the suggestion of one of the reviewers we explored the association of a genetic variant (rs738409 C >G SNP) that has been shown to be a robust predictor of CT-assessed NAFLD40–42 with our ultrasound scan (USS) and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) markers of NAFLD using logistic regression
Summary
Adolescent non-alcoholic fatty liver disease (NAFLD) is associated with cardiometabolic risk factors. We have attempted to determine the differences in metabolic profile of adolescents with and without markers of NAFLD. Results: All three indicators of NAFLD were associated with ~0.5 standard deviation (SD) greater concentrations of all extremely large to small very low-density lipoproteins (VLDL) measures. Concentrations of most cholesterols, including remnant cholesterol, all triglycerides and monounsaturated fatty acids, in addition to glycoprotein acetyls (inflammatory marker), were higher in participants with NAFLD. Conclusions: We have identified differing metabolic profiles between adolescents with and without indicators of NAFLD. These results provide the foundations for future research to determine whether these differences persist and result in adverse future cardiometabolic health
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