Endothelial dysfunction in children with obesity-induced metabolic dysfunction-associated liver disease: Relationship to plasminogen activator inhibitor-1

IF 0.6 Q4 PEDIATRICS

PROGRESS IN PEDIATRIC CARDIOLOGY Pub Date : 2025-02-04 DOI:10.1016/j.ppedcard.2024.101797

Hekma Saad Farghaly , Kotb Abbass Metwalley , Edrees Zaki , Shimaa Khalaf , Omima Abdel-Rahman , Ghada Mohamed Saied , Magdy Algowhary , Shimaa Kamal Mohamed

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引用次数: 0

Abstract

Background

Metabolic dysfunction-associated fatty liver disease (MAFLD), formerly known as non-alcoholic fatty liver disease (NAFLD), and cardiovascular abnormalities are closely related in adulthood, but few studies were performed in childhood to prove this relationship, and its pathophysiologic mechanisms have not fully studied yet.

Objectives

This study aims to assess vascular endothelial dysfunction in children with obesity- related MAFLD and to investigate its relationship to the plasminogen activator inhibitor-1 (PAI-1) levels.

Methods

In this case-control study, we assessed both brachial flow-mediated dilation (FMD) and carotid intima-media thickness (CA-IMT), in addition to liver profile, lipid profile, glucose, insulin, insulin resistance, fasting C-peptide, high-sensitivity C-reactive protein (hs-CRP), and PAI-1 in 200 children with obesity, 80 with and 120 without MAFLD, respectively.

Results

Compared with non-MAFLD, children with MAFLD had lower brachial FMD% (3.94 ± 1.42 versus 8.16 ± 2.32 p = 0.001), similar CA-IMT (0.45 ± 0.06 versus 0.45 ± 0.07, p = 0.09) and higher PAI-1 (55.16 ± 14.42 versus 43.32 ± 10.34 p = 0.000). Moreover, FMD% was significantly correlated with PAI-1 (r = −0.57, p = 0.001), hs-CRP (r = −0.474, p = 0.001), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (r = −0.306, p = 0.01) and CA-IMT (r = −0.223, p <0.05). Using linear regression analysis, PAI-1 was the most significant independent predictor of FMD (p=0.001) in children with obesity-related MAFLD.

Conclusions

Children with obesity who have MAFLD showed impairment of FMD %, which was independently associated with elevated PAI-1 levels. Thus, the diagnosis of MAFLD in a child should raise urgent attention to its cardiovascular sequelae. In the management of MAFLD, the prevention of cardiovascular disease is crucial, along with the prevention of end-stage liver disease.

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来源期刊

PROGRESS IN PEDIATRIC CARDIOLOGY PEDIATRICS-

CiteScore

0.90

自引率

11.10%

发文量

审稿时长

75 days

期刊介绍： Progress in Pediatric Cardiology is an international journal of review presenting information and experienced opinion of importance in the understanding and management of cardiovascular diseases in children. Each issue is prepared by one or more Guest Editors and reviews a single subject, allowing for comprehensive presentations of complex, multifaceted or rapidly changing topics of clinical and investigative interest.