Korean J Pediatr.  2019 Dec;62(12):450-455. 10.3345/kjp.2019.00248.

Lipid accumulation product is a predictor of nonalcoholic fatty liver disease in childhood obesity

• Özcabı B
• Demirhan S
• Akyol M
• Öztürkmen Akay H
• Güven A

• KMID: 2469015
• DOI: http://doi.org/10.3345/kjp.2019.00248

Abstract

BACKGROUND
Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults. PURPOSE: Here we evaluated the ability of LAP to predict NAFLD in obese children.
METHODS
Eighty obese children (38 girls; age 6-18 years) were included. Anthropometric measurements and biochemical values were obtained from the patients' medical records. LAP was calculated as [waist circumference (WC) (cm) - 58]×triglycerides (mmol/L) in girls; [WC (cm) - 65]×triglycerides (mmol/L) in boys. The minLAP and adjLAP were described (3% and 50% of WC values, respectively) and the total/high-density lipoprotein cholesterol index (TC/HDL-C) was calculated. NAFLD was observed on ultrasound, and patients were divided into 3 groups by steatosis grade (normal, grade 0; mild, grade 1; moderate-severe, grade 2-3). The area under the curve (AUC) and appropriate index cutoff points were calculated by receiver operator characteristic analysis.
RESULTS
LAP was positively correlated with puberty stage (rho=0.409; P<0.001), fasting insulin (rho=0.507; P<0.001), homeostasis model assessment of insulin resistance (rho=0.470; P<0.001), uric acid (rho=0.522; P<0.001), and TC/HDL-C (rho=0.494; P<0.001) and negatively correlated with HDL-C (rho=-3.833; P<0.001). LAP values could be used to diagnose hepatosteatosis (AUC=0.698; P=0.002). The LAP, adjLAP, and minLAP cutoff values were 42.7 (P=0.002), 40.05 (P=0.003), and 53.47 (P=0.08), respectively. For LAP, the differences between the normal and mild groups (P=0.035) and the normal and moderate-severe groups were statistically significant (P=0.037), whereas the difference between the mild and moderate-severe groups was not (P>0.005). There was a statistically significant difference between the normal and mild groups for adjLAP (P=0.043) but not between the other groups (P>0.005). There was no significant intergroup difference in minLAP (P>0.005).
CONCLUSION
LAP is a powerful and easy tool to predict NAFLD in childhood. If LAP is ≥42.7, NAFLD should be suspected. This is the first study to assess LAP diagnostic accuracy for childhood obesity.

Keyword

Childhood obesity; Lipid accumulation product; Nonalcoholic fatty liver disease; Total cholesterol/high-density lipoprotein cholesterol; Waist circumference

MeSH Terms

Adolescent
Adult
Child
Cholesterol
Fasting
Female
Homeostasis
Humans
Insulin
Insulin Resistance
Lipid Accumulation Product*
Lipoproteins
Medical Records
Non-alcoholic Fatty Liver Disease*
Obesity*
Pediatric Obesity
Puberty
Ultrasonography
Uric Acid
Waist Circumference
Cholesterol
Insulin
Lipoproteins
Uric Acid