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Relation between severity of NAFLD and insulin resistance in obese children

H El-Khayat*, Mohamed TH Sallam, Safaa Salama, Heba E El-Kholy

Background: With increasing prevalence of childhood obesity worldwide, Non-Alcoholic Fatty Liver Disease (NAFLD) became the most common cause of chronic liver disease in obese children. Insulin resistance is the main risk factor of NAFLD. NAFLD is asymptomatic in early stages. Early diagnosis and treatment of risk factor is essential in treatment and slowing down the disease progression. Aim: This study was designed to detect the relationship between severity of fatty liver and insulin resistance. Methods: This cross sectional study was conducted on 20 obese children with NAFLD aged from 4-12 years old. All children were subjected to full medical, dietetic history, full anthropometric measurements including weight, height, BMI, waist circumference, hip circumference, Waist to Hip Ratio (WHR), Waist to Height Ratio (WHtR), body composition, laboratory investigations including fasting glucose, fasting insulin and HOMA-IR was calculated and abdominal ultrasound . Results: 80% of the study group was males and 20% were females. The prevalence of grade 1 mild steatosis was 75% and grade 2 moderate steatosis was 25%. And 46.7% of children with grade 1 steatosis had moderate insulin resistance and 6.7% had severed insulin resistance. 100% of children with grade 2 steatosis have severed insulin resistance. Waist Hip Ratio (WHR) showed highly statistically significant association with NAFLD grade with p value (p<0.001), also Waist Height Ratio (WHtR) was highly statistical significant associated with NAFLD grade with p value (p<0.001). Also there was a statistically significant positive correlation between WHR and WHtR with fasting insulin and HOMA IR. In the study group, there was highly positive significant correlation between NAFLD grades and fasting insulin level and HOMA-IR with p value (p<0.001), but there was non-significant correlation between NAFLD grades and fasting glucose level. Conclusion: HOMA-IR has highly significant relation with NAFLD grade so, early detection of steatosis by HOMA-IR calculation is very important to prevent progression of liver disease.