Sex-specific differences in ectopic fat and metabolic characteristics of paediatric nonalcoholic fatty liver disease

• Published in: International Journal of Obesity 2024-04, Vol.48 (4), p.486-494
• Main Authors: Lee, Eun Hye, Kim, Ji Young, Yang, Hye Ran
• Format: Article
• Language: English
• Subjects: 14/63; 59/57; 692/163/2743/393; 692/699/1503/1702/393; 692/699/1702/393; 692/700/1720; Adolescent; Biopsy; Blood pressure; Body composition; Body fat; Body Mass Index; Body size; Child; Children; Children & youth; Diabetes mellitus; Dyslipidemia; Epidemiology; Fasting; Fatty liver; Female; Gender differences; Health Promotion and Disease Prevention; Homeostasis; Hormones; Humans; Hypertension; Insulin; Insulin Resistance; Internal Medicine; Laboratory tests; Lipids; Liver; Liver - pathology; Liver diseases; Magnetic resonance imaging; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic disorders; Metabolic syndrome; Metabolism; Non-alcoholic Fatty Liver Disease; Obesity; Public Health; Sex Characteristics; Sex differences; Sex hormones; Steatosis; Uric Acid
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/s41366-023-01439-6

Background/Objectives Sex-specific differences in obesity-related metabolic characteristics of non-alcoholic fatty liver disease (NAFLD) have rarely been explored, particularly in children with biopsy-verified NAFLD. The influence of sex hormones on ectopic fat disposition may cause inter-sex differences in various metabolic factors. This study aimed to assess the sex-based differences in ectopic fat and metabolic characteristics in children with NAFLD. Subject/Methods We enrolled 63 children with biopsy-verified NAFLD (48 boys; mean age, 12.9 ± 3.2 years; mean body mass index z-score [BMI-z], 2.49 ± 1.21). Ectopic fat in the liver and pancreas was quantified based on magnetic resonance imaging within 2 days of the liver biopsy. Laboratory tests, body composition, blood pressure, and anthropometric measurements were also assessed. Results Sex-based differences were neither observed in age, BMI-z, or total body fat percentage nor in the proportions of obesity, abdominal obesity, diabetes, dyslipidaemia, hypertension, or metabolic syndrome. Furthermore, liver enzyme levels, lipid profiles, and pancreatic fat did not differ between the sexes. However, boys had significantly higher fasting insulin (median 133.2 vs . 97.8 pmol/L; p  = 0.039), fasting plasma glucose (median 5.30 vs . 4.83 mmol/L; p  = 0.013), homeostasis model assessment of insulin resistance (median 5.4 vs . 3.6; p  = 0.025), serum uric acid (404.1 ± 101.2 vs . 322.4 ± 87.1 μmol/L; p  = 0.009), and liver fat (median 26.3% vs . 16.3%; p  = 0.014). Conclusions Male-predominant hepatic steatosis and insulin resistance caused by sex-specific ectopic fat accumulation may contribute to higher uric acid levels in boys than in girls with NAFLD.