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Determinants of hyp...
Determinants of hyperglucagonemia in pediatric non-alcoholic fatty liver disease
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- Maruszczak, Katharina (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Obes Res Unit, Salzburg, Austria.
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- Radzikowski, Konrad (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Obes Res Unit, Salzburg, Austria.
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- Schuetz, Sebastian (författare)
- Paris Lodron Univ, Dept Math, Salzburg, Austria.
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- Mangge, Harald (författare)
- Med Univ Graz, Clin Inst Med & Chem Lab Diagnost, Graz, Austria.
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- Bergsten, Peter (författare)
- Uppsala universitet,Institutionen för medicinsk cellbiologi
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- Forslund, Anders, 1961- (författare)
- Uppsala universitet,Institutionen för kvinnors och barns hälsa
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- Manell, Hannes (författare)
- Uppsala universitet,Institutionen för kvinnors och barns hälsa
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- Pixner, Thomas (författare)
- Salzkammergutklinikum Voecklabruck, Dept Pediat & Adolescent Med, Voecklabruck, Austria.
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- Ahlstrom, Hakan, 1953- (författare)
- Uppsala universitet,Radiologi,Antaros Med, BioVenture Hub, Mölndal, Sweden.
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- Kullberg, Joel, 1979- (författare)
- Uppsala universitet,Radiologi,Antaros Med, BioVenture Hub, Mölndal, Sweden.
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- Moerwald, Katharina (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Obes Res Unit, Salzburg, Austria.
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- Weghuber, Daniel (författare)
- Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Obes Res Unit, Salzburg, Austria.
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Paracelsus Med Univ, Univ Hosp Salzburg, Dept Pediat, Obes Res Unit, Salzburg, Austria Paris Lodron Univ, Dept Math, Salzburg, Austria. (creator_code:org_t)
- 2022-09-05
- 2022
- Engelska.
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Ingår i: Frontiers in Endocrinology. - : Frontiers Media S.A.. - 1664-2392. ; 13
- Relaterad länk:
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https://doi.org/10.3...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.3...
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Abstract
Ämnesord
Stäng
- ObjectiveOver the years, non-alcoholic fatty liver (NAFLD) disease has progressed to become the most frequent chronic liver disease in children and adolescents. The full pathology is not yet known, but disease progression leads to cirrhosis and hepatocellular carcinoma. Risk factors included hypercaloric diet, obesity, insulin resistance and genetics. Hyperglucagonemia appears to be a pathophysiological consequence of hepatic steatosis, thus, the hypothesis of the study is that hepatic fat accumulation leads to increased insulin resistance and impaired glucagon metabolism leading to hyperglucagonemia in pediatric NAFLD. Methods132 children and adolescents between 10 and 18 years, with varying degrees of obesity, were included in the study. Using Magnetic Resonance Imaging (MRI) average liver fat was determined, and patients were stratified as NAFLD (>5% liver fat content) and non-NAFLD (<5%). All patients underwent a standardized oral glucose tolerance test (OGTT). Additionally, anthropometric parameters (height, weight, BMI, waist circumference, hip circumference) such as lab data including lipid profile (triglycerides, HDL, LDL), liver function parameters (ALT, AST), uric acid, glucose metabolism (fasting insulin and glucagon, HbA1c, glucose 120 min) and indices evaluating insulin resistance (HIRI, SPISE, HOMA-IR, WBISI) were measured. ResultsChildren and adolescents with NAFLD had significantly higher fasting glucagon values compared to the non-NAFLD cohort (p=0.0079). In the NAFLD cohort univariate analysis of fasting glucagon was associated with BMI-SDS (p<0.01), visceral adipose tissue volume (VAT) (p<0.001), average liver fat content (p<0.001), fasting insulin concentration (p<0.001), triglycerides (p<0.001) and HDL (p=0.034). This correlation equally applied to all insulin indices HOMA-IR, WBISI, HIRI (all p<0.001) and SPISE (p<0.002). Multivariate analysis (R-2 adjusted 0.509) for the same subgroup identified HIRI (p=0.003) and VAT volume (p=0.017) as the best predictors for hyperglucagonemia. Average liver fat content is predictive in pediatric overweight and obesity but not NAFLD. ConclusionsChildren and adolescents with NAFLD have significantly higher fasting plasma glucagon values, which were best predicted by hepatic insulin resistance and visceral adipose tissue, but not average liver fat content.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Nyckelord
- glucagon
- childhood obesity
- NAFLD
- pediatrics
- hyperglucagonemia
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Maruszczak, Kath ...
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Radzikowski, Kon ...
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Schuetz, Sebasti ...
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Mangge, Harald
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Bergsten, Peter
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Forslund, Anders ...
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Manell, Hannes
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Pixner, Thomas
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Ahlstrom, Hakan, ...
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Kullberg, Joel, ...
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Moerwald, Kathar ...
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Weghuber, Daniel
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