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http://dx.doi.org/10.3345/kjp.2019.00248

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)
Publication Information
Clinical and Experimental Pediatrics / v.62, no.12, 2019 , pp. 450-455 More about this Journal
Abstract
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.
Keywords
Childhood obesity; Lipid accumulation product; Nonalcoholic fatty liver disease; Total cholesterol/high-density lipoprotein cholesterol; Waist circumference;
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1 Kahn HS. The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord 2005;5:26.   DOI
2 Taverna MJ, Martinez-Larrad MT, Frechtel GD, Serrano-Rios M. Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population. Eur J Endocrinol 2011;164:559-67.   DOI
3 Chiang JK, Koo M. Lipid accumulation product: a simple and accurate index for predicting metabolic syndrome in Taiwanese people aged 50 and over. BMC Cardiovasc Disord 2012;12:78.   DOI
4 Xiang S, Hua F, Chen L, Tang Y, Jiang X, Liu Z. Lipid accumulation product is related to metabolic syndrome in women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes 2013;121:115-8.   DOI
5 Tola EN, Yalcin SE, Dugan N. The predictive effect of inflammatory markers and lipid accumulation product index on clinical symptoms associated with polycystic ovary syndrome in nonobese adolescents and younger aged women. Eur J Obstet Gynecol Reprod Biol 2017; 214:168-72.   DOI
6 Chan L, Xue H, Xiaoya Z, Jiajia X, Wei R, Linman L, et al. Lipid accumulation product: a simple and accurate index for predicting metabolic syndrome in patients with adult growth hormone deficiency. Exp Clin Endocrinol Diabetes 2016;124:220-4.   DOI
7 Dai H, Wang W, Chen R, Chen Z, Lu Y, Yuan H. Lipid accumulation product is a powerful tool to predict non-alcoholic fatty liver disease in Chinese adults. Nutr Metab (Lond) 2017;14:49.   DOI
8 Vajro P, Lenta S, Socha P, Dhawan A, McKiernan P, Baumann U, et al. Diagnosis of nonalcoholic fatty liver disease in children and adolescents: position paper of the ESPGHAN Hepatology Committee. J Pediatr Gastroenterol Nutr 2012;54:700-13.   DOI
9 Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc 2017;92:251-65.   DOI
10 Neyzi O, Bundak R, Gokcay G, Gunoz H, Furman A, Darendeliler F, et al. Reference values for weight, height, head circumference, and body mass index in turkish children. J Clin Res Pediatr Endocrinol 2015;7:280-93.   DOI
11 Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291-303.   DOI
12 Hatipoglu N, Ozturk A, Mazicioglu MM, Kurtoglu S, Seyhan S, Lokoglu F. Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr 2008;167:383-9.   DOI
13 Lee SS, Park SH. Radiologic evaluation of nonalcoholic fatty liver disease. World J Gastroenterol 2014;20:7392-402.   DOI
14 Keskin M, Kurtoglu S, Kendirci M, Atabek ME, Yazici C. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 2005;115:e500-3.   DOI
15 Millan J, Pinto X, Munoz A, Zuniga M, Rubies-Prat J, Pallardo LF, et al. Lipoprotein ratios: Physiological significance and clinical usefulness in cardiovascular prevention. Vasc Health Risk Manag 2009; 5:757-65.
16 Shannon A, Alkhouri N, Carter-Kent C, Monti L, Devito R, Lopez R, et al. Ultrasonographic quantitative estimation of hepatic steatosis in children With NAFLD. J Pediatr Gastroenterol Nutr 2011;53:190-5.   DOI
17 Lee JH, Jeong SJ. What is the appropriate strategy for diagnosing NAFLD using ultrasonography in obese children? World J Pediatr 2017;13:248-54.   DOI
18 Jain V, Jana M, Upadhyay B, Ahmad N, Jain O, Upadhyay AD, et al. Prevalence, clinical & biochemical correlates of non-alcoholic fatty liver disease in overweight adolescents. Indian J Med Res 2018;148: 291-301.   DOI
19 Boyraz M, Hatipoglu N, Sari E, Akcay A, Taskin N, Ulucan K, et al. Non-alcoholic fatty liver disease in obese children and the relationship between metabolic syndrome criteria. Obes Res Clin Pract 2014; 8:e356-63.   DOI
20 Lin YC, Chang PF, Yeh SJ, Liu K, Chen HC. Risk factors for liver steatosis in obese children and adolescents. Pediatr Neonatol 2010;51: 149-54.   DOI
21 Nobili V, Alkhouri N, Bartuli A, Manco M, Lopez R, Alisi A, et al. Severity of liver injury and atherogenic lipid profile in children with nonalcoholic fatty liver disease. Pediatr Res 2010;67:665-70.   DOI
22 Yuan H, Yu C, Li X, Sun L, Zhu X, Zhao C, et al. serum uric acid levels and risk of metabolic syndrome: a dose-response meta-analysis of prospective studies. J Clin Endocrinol Metab 2015;100:4198-207.   DOI