Nonalcoholic fatty liver disease in Hispanic youth with dysglycemia: risk for subclinical atherosclerosis?

F Bacha, A Tomsa, SK Bartz, SE Barlow… - Journal of the …, 2017 - academic.oup.com
F Bacha, A Tomsa, SK Bartz, SE Barlow, ZD Chu, R Krishnamurthy, R Krishnamurthy
Journal of the Endocrine Society, 2017academic.oup.com
Abstract Context Obese Hispanic adolescents (OHAs) with dysglycemia have increased
cardiovascular disease risk burden. Objective To investigate if nonalcoholic fatty liver
disease (NAFLD) confers added risk for endothelial dysfunction in these youth. Design
Cross-sectional study. Setting Academic institution. Participants Thirty-six OHAs (15.3±0.4
years), 20 with prediabetes and 16 with type 2 diabetes, with and without NAFLD.
Intervention Evaluation of reactive hyperemia index (RHI) and augmentation index (AIx) by …
Context
Obese Hispanic adolescents (OHAs) with dysglycemia have increased cardiovascular disease risk burden.
Objective
To investigate if nonalcoholic fatty liver disease (NAFLD) confers added risk for endothelial dysfunction in these youth.
Design
Cross-sectional study.
Setting
Academic institution.
Participants
Thirty-six OHAs (15.3 ± 0.4 years), 20 with prediabetes and 16 with type 2 diabetes, with and without NAFLD.
Intervention
Evaluation of reactive hyperemia index (RHI) and augmentation index (AIx) by peripheral arterial tonometry; muscle, hepatic, and adipose tissue insulin sensitivity (IS; hyperinsulinemic-euglycemic clamp 80 mu/m2/min, with [6,6 2H2]glucose and [2H5] glycerol); body composition; and abdominal and hepatic fat by magnetic resonance imaging/spectroscopy.
Outcome Measures
RHI and AIx.
Hypothesis
OHAs with dysglycemia and NAFLD have worse RHI and AIx vs those without NAFLD.
Results
The NAFLD (n = 23) and non-NAFLD (n = 13) groups were of similar age, sex, glycemic status, body mass index, % body fat and abdominal fat. The NAFLD group had higher hepatic fat (P < 0.001) lower skeletal muscle IS (P = 0.01), hepatic IS (P = 0.01), and adipose tissue IS (P = 0.04). The NAFLD vs non-NAFLD group had lower RHI (1.4 ± 0.05 vs 1.7 ± 0.09, P = 0.002), greater AIx (–6.0 ± 1.6 vs –12.0 ± 2.1, P = 0.03). Hepatic fat was inversely related to RHI (r = –0.49, P = 0.002) and positively related to AIx (r = 0.45, P = 0.006). Hepatic IS (r = –0.42, P = 0.01) and adipose IS (r = –.54, P = 0.001) correlated with arterial stiffness (AIx).
Conclusion
In OHAs with dysglycemia, NAFLD is associated with worse endothelial function. RHI and AIx were related to hepatic fat content. Vascular stiffness was related to hepatic and adipose tissue insulin resistance.
Oxford University Press