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Insulin resistance and the metabolic syndrome are related to the severity of steatosis in the pediatric population with obesity.

Insulin resistance and the metabolic syndrome are related to the severity of steatosis in the pediatric population with obesity.
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Ubiña-Aznar E, Tapia-Ceballos L, Rosales-Zabal JM, Porcel-Chacón R, Poveda-Gómez F, Lozano-Calero C, Ortiz-Cuevas C, Rivas-Ruiz F, Sánchez Cantos A, Navarro Jarabo JM,


Ubiña-Aznar E, Tapia-Ceballos L, Rosales-Zabal JM, Porcel-Chacón R, Poveda-Gómez F, Lozano-Calero C, Ortiz-Cuevas C, Rivas-Ruiz F, Sánchez Cantos A, Navarro Jarabo JM, (click to view)

Ubiña-Aznar E, Tapia-Ceballos L, Rosales-Zabal JM, Porcel-Chacón R, Poveda-Gómez F, Lozano-Calero C, Ortiz-Cuevas C, Rivas-Ruiz F, Sánchez Cantos A, Navarro Jarabo JM,

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Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva 2017 08 04109() doi 10.17235/reed.2017.4898/2017
Abstract
BACKGROUND
To determine the factors associated with an increased risk for severe steatosis (SS) and establish the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) as a screening tool.

METHODS
A cross-sectional study was performed in obese children to assess the relationship between the metabolic syndrome (MetS) and glucose metabolism alterations (GMA) and the risk for severe steatosis.

RESULTS
A total of 94 children (51 males) aged from six to 14 years were included. Thirteen children (14.8%) had severe steatosis (SS). The anthropometric variables associated with SS included body mass index (BMI) (SS 34.1 vs non-SS 29.7, p = 0.005), waist circumference (cm) (100 vs 92.5, p = 0.015) and hip circumference (cm) (108 vs 100, p = 0.018). The blood parameters included alanine aminotransferase (ALT) (UI/dl) (27 vs 21, p = 0.002), gamma-glutamil transpeptidase (GGT) (UI/dl) (16 vs 15, p = 0.017), fasting glycemia (mg/dl) (96 vs 88, p = 0.006), fasting insulin (UI/dl) (25 vs 15.3, p < 0.001) and HOMA-IR score (7.1 vs 3.7, p < 0.001). Eighteen children with MetS were found to be at an increased risk for severe steatosis (odds ratio [OR] 11.36, p < 0.001). After receiver operating characteristic (ROC) curve analysis, the best area under the curve (AUC) was obtained for HOMA-R of 0.862. The HOMA-R 4.9 cut-off value had a 100% sensitivity (CI 95%: 96.2-100) and 67.9% specificity (CI 95%: 57.1-78.7) for severe steatosis. CONCLUSIONS
The presence of MetS and glucose metabolism alterations are risk factors for severe steatosis. The 4.9 cut-off value for HOMA-IR may be a risk factor for severe steatosis in obese children.

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