Are saturated fatty acids and insulin resistance associated with fatty liver in obese children?

Background: Fatty liver (FL) is a common cause of liver disease in children. Obesity and insulin resistance (IR) play an important role in pathogenesis of FL. Diet has been reported to affect IR and possibly FL. The purpose of this study was to investigate certain parameters (anthropometric, biochemical, dietary intake) of obese Greek children with and without FL. Methods: Forty-three obese children aged 9-14 (25 boys/18 girls) participated in the study. FL was diagnosed by ultrasonography (US). Liver indexes (ALT, AST, γ-GT) were measured in all children. A 3-day dietary was recorded for all subjects. None of the subjects were positive for viral hepatitis or had a history of consuming alcohol. Results: Eighteen out of 43 subjects (41.8%) had FL based on US. Intakes of carbohydrates and simple refined carbohydrates were significantly higher in subjects with FL compared to children without FL, while saturated fatty acids (SFA) were proportionally increased to the degree of hepatic steatosis. In multiple regression analysis of factors associated with FL, only HOMA-IR [Beta: 0.160, 95%CI (0.122-1.340), P < 0.001] and SFA [Beta: 0.455, 95%CI (0.129-2.129), P < 0.001] were the most significant one. Conclusions: Our results suggest that high intake of carbohydrates and simple refined carbohydrates as well as low intake of fiber may be correlated with the pathogenesis of FL. Moreover, IR and high intake of SFA are independently associated with FL in obese children.