Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Lipid accumulation product is a predictor of nonalcoholic fatty liver disease in childhood obesity

  • Ozcabi, Bahar (Division of Pediatric Endocrinology, Health Science University Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital) ;
  • Demirhan, Salih (Department of Pediatrics, Health Science University Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital) ;
  • Akyol, Mesut (Department of Biostatistics, Yildirim Beyazit University) ;
  • Akay, Hatice Ozturkmen (Department of Radiology, Health and Science University Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital) ;
  • Guven, Ayla (Division of Pediatric Endocrinology, Health Science University Zeynep Kamil Maternity and Children's Diseases Training and Research Hospital)
  • 투고 : 2019.03.13
  • 심사 : 2019.10.21
  • 발행 : 2019.12.15
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초록

Background: Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults. Purpose: Here we evaluated the ability of LAP to predict NAFLD in obese children. Methods: Eighty obese children (38 girls; age 6-18 years) were included. Anthropometric measurements and biochemical values were obtained from the patients' medical records. LAP was calculated as [waist circumference (WC) (cm) - 58]×triglycerides (mmol/L) in girls; [WC (cm) - 65]×triglycerides (mmol/L) in boys. The minLAP and adjLAP were described (3% and 50% of WC values, respectively) and the total/high-density lipoprotein cholesterol index (TC/HDL-C) was calculated. NAFLD was observed on ultrasound, and patients were divided into 3 groups by steatosis grade (normal, grade 0; mild, grade 1; moderate-severe, grade 2-3). The area under the curve (AUC) and appropriate index cutoff points were calculated by receiver operator characteristic analysis. Results: LAP was positively correlated with puberty stage (rho=0.409; P<0.001), fasting insulin (rho= 0.507; P<0.001), homeostasis model assessment of insulin resistance (rho=0.470; P<0.001), uric acid (rho=0.522; P<0.001), and TC/HDL-C (rho=0.494; P<0.001) and negatively correlated with HDL-C (rho=-3.833; P<0.001). LAP values could be used to diagnose hepatosteatosis (AUC=0.698; P=0.002). The LAP, adjLAP, and minLAP cutoff values were 42.7 (P=0.002), 40.05 (P=0.003), and 53.47 (P= 0.08), respectively. For LAP, the differences between the normal and mild groups (P=0.035) and the normal and moderate-severe groups were statistically significant (P=0.037), whereas the difference between the mild and moderate-severe groups was not (P>0.005). There was a statistically significant difference between the normal and mild groups for adjLAP (P=0.043) but not between the other groups (P>0.005). There was no significant intergroup difference in minLAP (P>0.005). Conclusion: LAP is a powerful and easy tool to predict NAFLD in childhood. If LAP is ≥42.7, NAFLD should be suspected. This is the first study to assess LAP diagnostic accuracy for childhood obesity.

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참고문헌

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  3. Cardiovascular Risk Factors and Subclinical Atherosclerosis in Greek Adolescents with Polycystic Ovary Syndrome: Its Relationship with Body Mass Index vol.9, pp.1, 2022, https://doi.org/10.3390/children9010004