Prevalence and Determinants of Hepatic Steatosis in Young Adult Women

 
 
 
 

Prevalence and Determinants of Hepatic Steatosis in Young Adult Women

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Title: Prevalence and Determinants of Hepatic Steatosis in Young Adult Women
Author: Xanthakos, Stavra A.
Description: The prevalence of nonalcoholic fatty liver disease (NAFLD) in children and young adults is unknown, as population-based studies are often limited by use of serum aminotransferases as surrogate markers, lacking imaging or biopsy data to confirm NAFLD. This study determines the prevalence and determinants of NAFLD in young adult females using magnetic resonance imaging (MRI) to measure hepatic steatosis. Prevalence was hypothesized to be 15%. Methods: 278 female subjects, ages 25-27 years, were recruited from a population-based cohort. Exclusion criteria included weight >300 lbs, daily alcohol intake >20 gm/day, hepatotoxic medications, or serologic evidence of hepatitis B, C or autoimmune hepatitis. Anthropometric indices, serum lipids, insulin, glucose and aminotransferases (ALT, GGT) were measured. The hepatic fat index (HFI) was measured using a biopsy-validated MRI technique. Descriptive statistics and nonparametric tests were used, analyzing races separately to control for higher prevalence of obesity in the black females. Results: 38% of the cohort was obese (BMI > 30 kg/m2), but only 4% had abnormal ALT (>35 IU/L). Black females (N=157) had a higher prevalence of obesity (47% vs. 27%, p<0.001), abnormal waist circumference (40% vs. 25%, p=0.02), hyperinsulinemia (54% vs. 30%, p<0.001) and metabolic syndrome (10% vs. 5%, p =0.15) compared to white females. Mean HFI was 3.0 ± 2.6 (range 0 - 26) with no significant racial differences. Prevalence of abnormal HFI was 2.5%, with no significant racial differences (blacks 1.9%, whites 3.3%). BMI, waist-hip ratio, waist circumference, triglycerides, and GGT directly correlated with HFI. Of subjects with abnormal HFI, 100% were obese and hyperinsulinemic, 80% had abnormal waist circumference, but only 29% had abnormal ALT. Conclusions: Despite a high prevalence of obesity, significant hepatic steatosis is not very prevalent in young black and white adult women. Black women have a significantly higher prevalence of risk factors for NAFLD, but a strikingly low prevalence of hepatic steatosis, confirming that black race may protect against NAFLD. Shorter duration of obesity due to young age may contribute to a lower than anticipated prevalence and severity of hepatic steatosis in this population-based cohort of young adult females.
Permanent Link: http://rave.ohiolink.edu/etdc/view?acc_num=ucin1155258455
http://hdl.handle.net/2374.OX/9558
Date: 2006

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