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Cut-Off Values of Visceral Adiposity to Predict NAFLD in Brazilian Obese Adolescents

DOI: 10.1155/2013/724781

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Abstract:

Objectives. The present study aimed at determining cut-off points of visceral fat to predict NAFLD and analyzed metabolic disorders of obese adolescents. Methods. Cross-sectional study involved 165 obese adolescents ranged in age from 15 to 19 years. Glycemia, hepatic transaminases, lipid profile, and insulin resistance were analyzed. Visceral and subcutaneous fat were measured by ultrasound and body composition by plesthysmography. Results. The NAFLD adolescents had significantly higher values for body mass, BMI-for-age, BMI, total fat, waist circumference, and visceral fat when compared with non-NAFLD obese adolescents in both genders. Moreover, there were significant positive correlations between visceral fat with the variables BMI-for-age ( ), TG ( ), AST ( ), ALT ( ), WC ( ), and visceral/subcutaneous ratio ( ) for NAFLD group. Total fat, triglycerides, and visceral fat were the independent predictors to NAFLD. Analysis of the ROC curves revealed cut-off points of visceral fat of 4.47?cm for girls and 4.21?cm for boys. Conclusions. The results may suggest that abdominal ultrasonography procedure may be a safe alternative method of assessing visceral adiposity aiming to be considered to the development of preventive and treatment strategies in obese individuals. This clinial trial is registered with ClinicalTrial.gov (NCT01358773). 1. Introduction Childhood obesity is a worldwide pandemic, with consequences that include an increased incidence of metabolic disorders, which may arise in part due to visceral obesity [1]. Nonalcoholic fatty liver disease (NAFLD) is an emerging public health concern that parallels rise in obesity and metabolic syndrome (MS) [2]. There is a growing prevalence about NAFLD in obese children. Previous study with obese adolescents, specifically, found a prevalence of NAFLD affect 52% of subjects. The evidence suggests that presence of insulin resistance and visceral obesity is strongly linked to pathogenesis of NAFLD which should also be considered part of the metabolic syndrome [2, 3]. In this way, several authors suggested that NAFLD is a hepatic manifestation of MS [4]. NAFLD comprises a disease spectrum ranging from simple steatosis to steatohepatitis (NASH), with varying degrees of inflammation and fibrosis, progressing to end-stage liver disease with cirrhosis [5, 6]. Feldstein et al. [7] reported a longitudinal study, describing a follow-up of up to 20 years, and demonstrated that with children NAFLD presented shorter long-term survival than the expected survival in the general population of the same age and gender.

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