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Associations of Insulin Resistance and Glycemia With Liver Enzymes in Hispanic/Latino Youths: Results From the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth).

TitleAssociations of Insulin Resistance and Glycemia With Liver Enzymes in Hispanic/Latino Youths: Results From the Hispanic Community Children's Health Study/Study of Latino Youth (SOL Youth).
Publication TypePublication
Year2019
AuthorsParrinello CM, Rudolph BJ, Lazo M, Gallo LC, Thyagarajan B, Cotler SJ, Qi Q, Seeherunvong T, Vidot DC, Strickler HD, Kaplan RC, Isasi CR
JournalJ Clin Gastroenterol
Volume53
Issue2
Paginatione46-e53
Date Published2019 02
ISSN1539-2031
KeywordsAdolescent, Alanine Transaminase, Aspartate Aminotransferases, Blood Glucose, Child, Cross-Sectional Studies, Female, gamma-Glutamyltransferase, Hispanic Americans, Humans, insulin resistance, Liver, Male, Non-alcoholic Fatty Liver Disease, Pediatric Obesity
Abstract

BACKGROUND: Associations of insulin resistance and hyperglycemia with a panel of liver enzymes have not been well studied in a young, heterogenous Hispanic/Latino population. We aimed to assess the associations of insulin resistance and glycemia with nonalcoholic fatty liver disease (NAFLD), as measured by liver enzymes and the pediatric NAFLD fibrosis index (PNFI), and whether these associations are modified by body mass index and mediated by inflammation or endothelial dysfunction.MATERIALS AND METHODS: We conducted a cross-sectional study of 1317 boys and girls aged 8 to 16 years from the Hispanic Community Children's Health Study/Study of Latino Youth. We used Poisson regression to assess the associations of fasting glucose, hemoglobin A1c, and homeostasis model assessment of insulin resistance (HOMA-IR) with elevated alanine aminotransferase (ALT) (>25 U/L in boys, >22 U/L in girls), aspartate aminotransferase (AST) (≥37 U/L), gamma-glutamyl transpeptidase (GGT) (≥17 U/L), and PNFI (≥9; a function of age, waist circumference, and triglyceride level).RESULTS: HOMA-IR was associated with elevated ALT, AST, GGT, and PNFI [prevalence ratios (95% confidence intervals) for each 1-unit increase in the natural log of HOMA-IR: 1.99 (1.40-2.81), 2.15 (1.12-4.12), 1.70 (1.26-2.30), and 1.98 (1.43-2.74), respectively]. Associations were observed in overweight/obese children, but not in normal weight children (P-interaction=0.04 for AST and P-interaction=0.07 for GGT). After further adjustment for adiponectin, high-sensitivity C-reactive protein, e-selectin, and PAI-1, associations of HOMA-IR with liver enzymes and PNFI were attenuated, but remained statistically significant for AST and PNFI.CONCLUSION: Insulin resistance was associated with NAFLD in overweight/obese Hispanic/Latino youth, and this association may be partially mediated by inflammation and endothelial dysfunction.

DOI10.1097/MCG.0000000000000946
Alternate JournalJ Clin Gastroenterol
PubMed ID29099463
PubMed Central IDPMC5934331
Grant ListP30 DK041296 / DK / NIDDK NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
R01 MD011389 / MD / NIMHD NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
K01 HL129892 / HL / NHLBI NIH HHS / United States
P30 DK111022 / DK / NIDDK NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
UL1 TR001073 / TR / NCATS NIH HHS / United States
UL1 TR002556 / TR / NCATS NIH HHS / United States
R01 HL136266 / HL / NHLBI NIH HHS / United States
R01 HL102130 / HL / NHLBI NIH HHS / United States
MS#: 
0416
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
ECI: 
Yes
Manuscript Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
Manuscript Status: 
Published