Liver fat in adult survivors of severe acute malnutrition
Liver fat in adult survivors of severe acute malnutrition
The association between severe acute malnutrition (SAM) in early childhood and liver fat in adults is unknown. We hypothesized that exposure to SAM, especially severe wasting, is associated with fatty liver later in life. In this observational study, abdominal CT was used to quantify mean liver attenuation (MLA) and liver:spleen attenuation ratio (L/S). Birth weight (BW), serum lipids, insulin resistance (homeostatic model assessment), anthropometry and intrabdominal fat were collected. Mean differences between diagnostic groups were tested and hierarchical regression analysis determined the best predictors of liver fat. We studied 88 adult SAM survivors and 84 community participants (CPs); age 29.0 ± 8.4 years, BMI 23.5 ± 5.0 kg/m2 (mean ± SDs). SAM survivors had less liver fat than CPs (using L/S) (p = 0.025). Severe wasting survivors (SWs) had lower BW (-0.51 kg; p = 0.02), were younger, thinner and had smaller waist circumference than oedematous malnutrition survivors (OMs). In the final regression model adjusting for age, sex, birth weight and SAM phenotype (i.e., oedematous malnutrition or severe wasting), SWs had more liver fat than OMs (using MLA) (B = 2.6 ± 1.3; p = 0.04) but similar liver fat using L/S (p = 0.07) and lower BW infants had less liver fat (MLA) (B = -1.8 ± 0.8; p = 0.03). Greater liver fat in SWs than OMs, despite having less body fat, supports our hypothesis of greater cardiometabolic risk in SWs. Other postnatal factors might influence greater liver fat in survivors of severe wasting, suggesting the need to monitor infants exposed to SAM beyond the acute episode.
Adipose Tissue, Birth Weight, Child, Preschool, Edema/complications, Humans, Infant, Liver, Severe Acute Malnutrition/complications, Survivors
Thompson, Debbie S.
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Royal-Thomas, Tamika Y.N.
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Tennant, Ingrid A.
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Soares, Deanne P.
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Byrne, Christopher D.
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Forrester, Terrence E.
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Gluckman, Peter D.
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Boyne, Michael S.
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7 March 2022
Thompson, Debbie S.
83dfccb1-6cc7-4d98-9cfe-2afdec3669fb
Royal-Thomas, Tamika Y.N.
21188df8-5c56-4f23-aea2-2a95b2342f76
Tennant, Ingrid A.
c6f0c672-3600-4e4b-85f8-756b3fea0cab
Soares, Deanne P.
2a6503b0-7d73-46d1-b7ee-8b4f0f68ee38
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Forrester, Terrence E.
d5ed0294-0713-4521-baf9-923f1cae5e7f
Gluckman, Peter D.
848950cf-af32-4664-94a1-b3e68d3f588c
Boyne, Michael S.
7d787822-30fc-42e4-b3d4-8d3df98dfabd
Thompson, Debbie S., Royal-Thomas, Tamika Y.N., Tennant, Ingrid A., Soares, Deanne P., Byrne, Christopher D., Forrester, Terrence E., Gluckman, Peter D. and Boyne, Michael S.
(2022)
Liver fat in adult survivors of severe acute malnutrition.
Scientific Reports, 12 (1), [3690].
(doi:10.1038/s41598-022-07749-5).
Abstract
The association between severe acute malnutrition (SAM) in early childhood and liver fat in adults is unknown. We hypothesized that exposure to SAM, especially severe wasting, is associated with fatty liver later in life. In this observational study, abdominal CT was used to quantify mean liver attenuation (MLA) and liver:spleen attenuation ratio (L/S). Birth weight (BW), serum lipids, insulin resistance (homeostatic model assessment), anthropometry and intrabdominal fat were collected. Mean differences between diagnostic groups were tested and hierarchical regression analysis determined the best predictors of liver fat. We studied 88 adult SAM survivors and 84 community participants (CPs); age 29.0 ± 8.4 years, BMI 23.5 ± 5.0 kg/m2 (mean ± SDs). SAM survivors had less liver fat than CPs (using L/S) (p = 0.025). Severe wasting survivors (SWs) had lower BW (-0.51 kg; p = 0.02), were younger, thinner and had smaller waist circumference than oedematous malnutrition survivors (OMs). In the final regression model adjusting for age, sex, birth weight and SAM phenotype (i.e., oedematous malnutrition or severe wasting), SWs had more liver fat than OMs (using MLA) (B = 2.6 ± 1.3; p = 0.04) but similar liver fat using L/S (p = 0.07) and lower BW infants had less liver fat (MLA) (B = -1.8 ± 0.8; p = 0.03). Greater liver fat in SWs than OMs, despite having less body fat, supports our hypothesis of greater cardiometabolic risk in SWs. Other postnatal factors might influence greater liver fat in survivors of severe wasting, suggesting the need to monitor infants exposed to SAM beyond the acute episode.
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s41598-022-07749-5
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Accepted/In Press date: 18 February 2022
Published date: 7 March 2022
Additional Information:
Funding Information:
This work was supported by the New Zealand Health Research Council Grant 09/052, Developmental Adaptation to an Obesogenic Environment Program, the Caribbean Public Health Agency (CARPHA) and a UWI Graduate Studies Research and Publications Grant.
We gratefully acknowledge the men and women who took part in the study. We also recognize Joan Patterson-McNamee, Kenesha Pencott-Brown, Hemoy Drummond, Lorraine Wilson, Diahann Knight and Stacey Chin for their work carried out at the Tropical Metabolism Research Unit, University of the West Indies, Kingston, Jamaica. CDB is supported in part by the Southampton NIHR Biomedical Research Centre.
Publisher Copyright:
© 2022, The Author(s).
Copyright:
Copyright 2022 Elsevier B.V., All rights reserved.
Keywords:
Adipose Tissue, Birth Weight, Child, Preschool, Edema/complications, Humans, Infant, Liver, Severe Acute Malnutrition/complications, Survivors
Identifiers
Local EPrints ID: 456565
URI: http://eprints.soton.ac.uk/id/eprint/456565
ISSN: 2045-2322
PURE UUID: 7857afcc-2f0e-46d7-9d89-f1d693a7ae1c
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Date deposited: 05 May 2022 16:34
Last modified: 18 Mar 2024 02:50
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Contributors
Author:
Debbie S. Thompson
Author:
Tamika Y.N. Royal-Thomas
Author:
Ingrid A. Tennant
Author:
Deanne P. Soares
Author:
Terrence E. Forrester
Author:
Peter D. Gluckman
Author:
Michael S. Boyne
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