Atherogenic disorders in adolescents with ultrasound signs of fatty hepatosis and hyperuricemia Contact details:
S.I. MALYAVSKAYA, A.V. LEBEDEV, G.N. KOSTROVA
Northern State Medical University, Arkhangelsk
Lebedev A.V. — Associate Professor of the Department of Pathological Physiology
Address: 51 prospekt Troitsky, Arkhangelsk, Russian Federation, 163069, tel.: +7 (8182) 21-57-25, e-mail: andruleb@yandex.ru
The purpose — to study the features and relationship of blood uric acid and metabolic atherogenic disorders in adolescents with fatty hepatosis.
Material and methods. The study of atherogenic disorders included the following groups: 1 — adolescents with fatty hepatosis and hyperuricemia (n = 44), 2 — adolescents with fatty hepatosis and normal blood uric acid levels (n = 76), 3 (comparison group) — adolescents without acute and chronic diseases (n = 220).
The study results showed higher values of average body mass index, waist circumference, triglycerides, total lipid peroxidation, glucose, HOMA index, insulin, C-reactive protein, and lower values of high-density lipoprotein cholesterol and 25-hydroxyvitamin D in the group of adolescents with fatty hepatosis and hyperuricemia, compared to the group with fatty hepatosis and normal blood uric acid levels and the comparison group. A correlation analysis in a group of adolescents with ultrasound signs of fatty hepatosis revealed a positive correlation of the uric acid level in the blood with the HOMA index (r = 0.45; p < 0.001), waist circumference (r = 0.45; p < 0.001), body mass index (r = 0.35; p < 0.001), insulin (r = 0.34; p = 0.007), glucose (r = 0.31; p < 0.024), total lipid peroxidation (r = 0.41; p < 0.015), triglycerides (r = 0.36; p = 0.014), and C-reactive protein (r = 0.31; p = 0.007), and a negative correlation with the 25-hydroxyvitamin D level (r = — 0.38; p = 0.001).
Conclusions. The study showed the possibility to use blood uric acid levels in fatty hepatosis in adolescents as an indicator of atherogenic metabolic disorders: insulin resistance, lipid peroxidation, dyslipidemia, chronic inflammation, and 25(OH)D insufficiency.
Key words: non-alcoholic fatty liver disease, fatty hepatosis, hyperuricemia, adolescents, atherogenic disorders.
(For citation: Malyavskaya S.I., Lebedev A.V., Kostrova G.N. Atherogenic disorders in adolescents with ultrasound signs of fatty hepatosis and hyperuricemia. Practical medicine. 2023. Vol. , № , P.)
REFERENCES
- Younossi Z., Anstee Q.M., Marietti M. et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol, 2018, vol. 15 (1), pp. 11–20. DOI: 10.1038/nrgastro.2017.109
- Peng L., Wu S., Zhou N., Zhu S., Liu Q., Li X. Clinical characteristics and risk factors of nonalcoholic fatty liver disease in children with obesity. BMC Pediatrics, 2021, vol. 21, p. 122. DOI: 10.1186/s12887-021-02595-2
- Maev I.V., Andreev D.N., Kucheryavyy Yu.A. Prevalence of non-alcoholic fatty liver disease in Russia: meta-analysis. Consilium Medicum, 2023, no. 25 (5), pp. 313–319 (in Russ.). DOI: 10.26442/20751753.2023.5.202155
- Anderson E.L., Howe L.D., Jones H.E., Higgins J.P., Lawlor D.A., Fraser A. The prevalence of non-alcoholic fatty liver disease in children and adolescents: a systematic review and meta-analysis. PLoS One, 2015, vol. 10, p. e0140908. DOI: 10.1371/journal.pone.0140908
- Lazebnik L.B., Golovanova E.V., Turkina S.V. et al. Non-alcoholic fatty liver disease in adults: clinical picture, diagnosis, treatment. Recommendations for therapists, third version. Eksperimental’naya i klinicheskaya gastroenterologiya, 2021, no. 1, pp. 4–52 (in Russ.). DOI: 10.31146/1682-8658-ecg-185-1-4-52
- Duell P.B., Welty F.K., Miller M. et al. Nonalcoholic fatty liver disease and cardiovascular risk: a scientific statement from the American Heart Association. Arterioscler Thromb Vasc Biol, 2022, vol. 42 (6), pp. e168–e185. DOI: 10.1161/ATV.0000000000000153
- Ivashkin V.T., Maevskaya M.V., Pavlov Ch.S. et al. Clinical recommendations for the diagnosis and treatment of non-alcoholic fatty liver disease of the Russian Society for the Study of the Liver and the Russian Gastroenterological Association. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii, 2016, vol. 26, no. 2, pp. 24–42 (in Russ.).
- Baranov A.A., Kuchma V.R., Skoblina N.A. et al. Basic patterns of morphofunctional development of children and adolescents in modern conditions. Vestnik Rossiyskoy Akademii meditsinskikh nauk, 2012, vol. 67, no. 12, pp. 35–40 (in Russ.). DOI: 10.15690/vramn.v67i12.479
- Bezrukikh M.M., Son’kin V.D., Farber D.A. Vozrastnaya fiziologiya (fiziologiya razvitiya rebenka) [Developmental physiology (physiology of child development)]. Moscow: Akademiya, 2002. 416 p.
- Cotter T.G., Rinella M. Nonalcoholic Fatty Liver Disease 2020: The State of the Disease. Gastroenterology, 2020, vol. 158, pp. 1851–1864.
- Stahl E.P., Dhindsa D.S., Lee S.K. et al. Nonalcoholic Fatty Liver Disease and the Heart. JACC State-of-the-Art Review. J. Am. Coll. Cardiol, 2019, vol. 73, pp. 948–963.
- Alderman M.H. Serum uric acid as a cardiovascular risk factor for heart disease. Current Hypertension Reports, 2001, vol. 3, rr. 184–189.
- Kızılay D.Ö., Şen S., Ersoy B. Associations Between Serum Uric Acid Concentrations and Cardiometabolic Risk and Renal Injury in Obese and Overweight Children. J Clin Res Pediatr Endocrinol, 2019, vol. 11 (3), pp. 262–269. DOI: 10.4274/jcrpe.galenos.2018.2019.0241
- Moulin-Mares S.R.A., Zaniqueli D., Oliosa P.R. et al. Uric acid reference values: report on 1750 healthy Brazilian children and adolescents. Pediatr Res, 2021, vol. 89, pp. 1855–1860. DOI: 10.1038/s41390-020-01185-9
- Statsenko M.E., Turkina S.V., Ustinova M.N. et al. Hyperuricemia as a predictor of non-alcoholic fatty liver disease. Yuzhno-Rossiyskiy zhurnal terapevticheskoy praktiki, 2022, no. 3 (2), pp. 19–24 (in Russ.). DOI: 10.21886/2712-8156-2022-3-2-19-24
- Petta S., Camma C., Cabibi D., Di Marco V., Craxi A. Hyperuricemia is associated with histological liver damage in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther, 2011, vol. 34 (7), pp. 757–766. DOI: 10.1111/j.1365-2036.2011.04788
- Bastos M.D., Poll F.A., Reuter C.P., Bastos B.D. et al. The border between obesity and metabolic disease in children and adolescents. Why and how to investigate? A review of the literature. Human Nutrition & Metabolism, 2023, vol. 33, p. 200208. DOI: 10.1016/j.hnm.2023.200208
- Jaruvongvanich V., Ahuja W., Wirunsawanya K., Wijarnpreecha K., Ungprasert P. Hyperuricemia is associated with nonalcoholic fatty liver disease activity score in patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol, 2017, vol. 29 (9), pp. 1031–1035. DOI: 10.1097/ MEG.0000000000000931
- Malyavskaya S.I., Lebedev A.V., Kostrova G.N. Hormonal and metabolic features of the puberty period in adolescents with ultrasound signs of fatty hepatosis (on the example of Arkhangelsk). Ekologiya cheloveka, 2022, vol. 29, no. 11, pp. 807–815 (in Russ.). DOI: 10.17816/humeco109055
- Malyavskaya S., Kostrova G., Kudryavtsev A.V., Lebedev A. Low vitamin D levels among children and adolescents in an Arctic population. Scandinavian Journal of Public Health, 2022. DOI: 10.1177/14034948221092
- Malyavskaya S.I., Lebedev A.V., Kostrova G.N., Fokina V.A., Semenov V.A. Metabolic atherogenic disorders in adolescents with fatty hepatosis. Prakticheskaya meditsina, 2021, vol. 19, no. 5, pp. 63–66 (in Russ.). DOI: 10.32000/2072-1757-2021-5-63-66
- Fu Ch.-Ch., Chen M.-Ch., Li Y.-M. et al. The risk factors for ultrasound-diagnosed non-alcoholic fatty liver disease among adolescents. Ann Acad Med Singap, 2009, vol. 38 (1), pp. 15–17.
- Nealkogol’naya bolezn’ pecheni v detskom vozraste, pod red. V.P. Novikovoy, E.I. Aleshinoy, M.M. Gurovoy [Non-alcoholic liver disease in childhood, edited by V.P. Novikova, E.I. Aleshina, M.M. Gurova]. Moscow: GEOTAR-Media, 2016. 176 p.
- Mosca A., Nobili V., De Vito R., Crudele A., Scorletti E., Villani A. et al. Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents. J Hepatol, 2017, vol. 66, pp. 1031–1036. DOI: 10.1016/j.jhep.2016.12.025
- Lanaspa M.A., Sanchez-Lozada L.G., Choi Y.J. et al. Uric acid induces hepatic steatosis by generation of mitochondrial oxidative stress: Potential role in fructose-dependent and -independent fatty liver. J. Biol. Chem, 2012, vol. 287, pp. 40732–40744.
- Lin H., Dai G., Huang S., Chen Z., Jin Z., He Z. Association between Serum Uric Acid and Liver Enzymes in Adults Aged 20 Years and Older in the United States: NHANES 2005–2012. J. Clin. Med, 2023, vol. 12, pp. 648. DOI: 10.3390/jcm12020648
- Choi Y.J., Shin H.S., Choi H.S., Park J.W. et al. Uric acid induces fat accumulation via generation of endoplasmic reticulum stress and SREBP-1c activation in hepatocytes. Lab Investig, 2014, vol. 94, pp. 1114–1125 DOI: 10.1038/labinvest.2014.98
- Wan X., Xu C., Lin Y., Lu C., Li D., Sang J. et al. Uric acid regulates hepatic steatosis and insulin resistance through the NLRP3 inflammasomedependent mechanism. J Hepatol., 2016., vol. 64, pp. 925–32 https://doi.org/10.1016/j.jhep.2015.11.022.
- Anstee Q.M., Targher G., Day C.P. Progression of NAFLD to diabetes mellitus, cardiovascular disease or cirrhosis. Nat Rev Gastroenterol Hepatol, 2013, vol. 10, pp. 330–344. DOI: 10.1038/nrgastro.2013.41
- Vos M.B., Abrams S.H., Barlow S.E. et al. NASPGHAN Clinical Practice Guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr, 2017, vol. 64 (2), pp. 319–334. DOI: 10.1097/MPG.0000000000001482
- Riachy R., Vandewalle B., Conte J.K., Kerr Conte J. et al. 1,25-dihydroxyvitamin D3 protects RINm5F and human islet cells against cytokine-induced apoptosis: implication of the antiapoptotic protein A20. Endocrinology, 2002, vol. 143 (12), pp. 4809–4819.
- Ye W.Z., Reis A.F., Dubois-Laforgue D. et al. Vitamin D receptor gene polymorphisms are associated with obesity in type 2 diabetic subjects with early age of onset. European Journal of Endocrinology, 2001, vol. 145 (2), pp. 181–186.