Association between obesity, dyslipidemia and insulin resistance with suspected fatty liver disease in Greek children with excess weight

Objective: This study investigates the association between dyslipidemia and fatty liver disease with body mass index (BMI), waist-to-height ratio (WHtR), waist circumference (WC) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) in children and adolescents with overweight or obesity. Methods: Data from 299 children with overweight or obesity (48% boys) with mean age 9.23±2.5 years were analyzed. Alanine aminotransferase (ALT) >25.8 U/L (boys) and >22.1 U/L (girls), was defined as abnormal. Student’s t-tests were computed for the comparison of mean values. Chi-square tests were used for the comparison of proportions. Results: Proportions of children with dyslipidemia and suspected nonalcoholic fatty liver disease (NAFLD) were 23.4% and 31.4% respectively. The percentage of children with NAFLD was 28.3% in those without dyslipidemia and 45% in those with dyslipidemia (p=0.015). BMI, WC and WHtR were not different between children with and without dyslipidemia. BMI was significantly higher in those with NAFLD (p=0.019). A stratified by gender analysis, showed that BMI, WC and WHtR were significantly higher in boys with NAFLD (p=0.009, 0.037, 0.049 respectively). WHtR≥0.5 and ΗΟΜΑ-IR≥3 were not significantly associated with the presence of dyslipidemia (p>0.999, 0.549 respectively), however ΗΟΜΑ-IR ≥3 was more frequent in children with NAFLD (p=0.011). A stratified by gender analysis, showed that the aforementioned association was evident only in boys (p=0.027). Conclusion: The severity of obesity and male gender are clinical indicators of increased risk of dyslipidemia and NAFLD among obese children and adolescents.