To investigate the presence of association between nonalcoholic fatty liver disease (
NAFLD) and subclinical atherosclerosis using carotid intima media thickness (c‐ IMT) in obese children and adolescents. Additionally, we wished to investigate the relationship between fatty liver and elevated liver enzymes. Methods
A total of 157 obese patients (78 boys and 79 girls, mean age: 11.3 ± 2.6 years, age range: 6–16 years) were enrolled in the study. Aminotransferase, fasting glucose and lipid levels were determined. An oral glucose tolerance test was performed. The c‐
IMTwas measured. Infectious and metabolic causes of elevated liver enzymes were excluded. The diagnosis of NAFLDwas based on ultrasound scan. Results
Obese patients with
NAFLDhad markedly increased carotid IMT(mean: 0.48 mm, 95% CI: 0.47–0.49) than those without NAFLD(mean: 0.45 mm 95% CI: 0.44‐0.45, p < 0.001). The presence of NAFLDsignificantly increased c‐ IMTwhether the patient had elevated liver enzyme or not ( ANOVA, p < 0.001). In a multiple‐regression model, only the presence of NAFLDwas associated with increased c‐ IMT( β= 0.031, SE( β) = 0.008, p < 0.001). Conclusion
Obese children and adolescents with
NAFLDare at risk of early atherosclerotic changes. As liver function tests are not sufficient to identify patients with fatty liver, ultrasonographic evaluation of NAFLDmight be considered in all obese children and adolescents.