Gender-specific differences in clinical and metabolic variables associated with NAFLD in a Mexican pediatric population

• Main Authors: Eréndira Villanueva-Ortega, María José Garcés-Hernández, Arturo Herrera-Rosas, Juan Carlos López-Alvarenga, Estibalitz Laresgoiti-Servitje, Galileo Escobedo, Gloria Queipo, Sergio Cuevas-Covarrubias, Guadalupe Nayely Garibay-Nieto
• Format: Article
• Language: English
• Published: Elsevier 2019-09-01
• Series: Annals of Hepatology
• Subjects: NAFLD; Children; Adolescents; Obesity; Gender
• Online Access: http://www.sciencedirect.com/science/article/pii/S1665268119303412

Introduction and Objectives: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and it is more prevalent in Hispanic males. The gender differences can be explained by body fat distribution, lifestyle, or sex hormone metabolism. We evaluated anthropometric and metabolic differences by gender in children with and without NAFLD. Methods: We included 194 participants (eutrophic, overweight, and individuals with obesity). The presence of NAFLD was determined using ultrasonography, and we evaluated the association between this disease with metabolic and anthropometric variables by gender. Results: The mean age was 10.64 ± 2.54 years. The frequency of NAFLD in boys was 24.51% and in girls was 11.96% (OR = 2.39; 95%CI = 1.10–5.19; p = 0.025). For girls, NAFLD was significantly associated with triglycerides (p = 0.012), homeostatic model assessment of insulin resistance (HOMA-IR) (p = 0.048), and the visceral adiposity index (VAI) (p = 0.024). The variables related to NAFLD in a gender-specific manner were body mass index (BMI) (p = 0.001), waist circumference (WC) (p < 0.001), HDL cholesterol (p = 0.021), alanine aminotransferase (ALT) (p < 0.001), and aspartate aminotransferase (AST) (p = 0.002). Conclusions: In our study NAFLD is more frequent in boys, only ALT, and no other clinical or metabolic variables, were associated with NAFLD in these patients. HOMA-IR, VAI, triglyceride levels, and ALT were associated with NAFLD only in girls. The ALT cut-off points for the development of NAFLD in our study were 28.5 U/L in females and 27.5 U/L in males. Our findings showed that NAFLD should be intentionally screened in patients with obesity, particularly in boys.