Metabolic Consequences of Hepatic Steatosis in Overweight and Obese Adolescents

• Autores: Brandy Wicklow, Kristy Wittmeier, Andrea MacIntosh, Elizabeth AC Sellers, Lawrence Ryner, Hacene Serrai, Heather J. Dean, Jonathan McGavock
• Localización: Diabetes care, ISSN-e 0149-5992, Vol. 35, Nº. 4, 2012, págs. 905-910
• Idioma: inglés
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  • To test the hypothesis that hepatic steatosis is associated with risk factors for type 2 diabetes in overweight and obese youth, mediated by cardiorespiratory fitness. This was a cross-sectional study comparing insulin sensitivity between 30 overweight and obese adolescents with hepatic steatosis, 68 over-weight and obese adolescents without hepatic steatosis, and 11 healthy weight adolescents without hepatic steatosis. Cardiorespiratory fitness was determined by a graded maximal exercise test on a cycle ergometer. Secondary outcomes included presence of metabolic syndrome and glucose response to a 75-g oral glucose challenge. The presence of hepatic steatosis was associated with 55% lower insulin sensitivity (P = 0.02) and a twofold greater prevalence of metabolic syndrome (P = 0.001). Differences in insulin sensitivity (3.5 vs. 4.5 mU * kg^sup -1^ * min^sup -1^, P = 0.03), prevalence of metabolic syndrome (48 vs. 20%, P = 0.03), and glucose area under the curve (816 vs. 710, P = 0.04) remained between groups after matching for age, sex, and visceral fat. The association between hepatic steatosis and insulin sensitivity (ß = -0.24, t = -2.29, P < 0.025), metabolic syndrome (ß = -0.54, t = -5.8, P < 0.001), and glucose area under the curve (ß = 0.33, t = 3.3, P < 0.001) was independent of visceral and whole-body adiposity. Cardiorespiratory fitness was not associated with hepatic steatosis, insulin sensitivity, or presence of metabolic syndrome. Hepatic steatosis is associated with type 2 diabetes risk factors independent of cardiorespiratory fitness, whole-body adiposity, and visceral fat mass.