• Priscila L Sanches, Aline de Piano, Raquel M S Campos, June Carnier, Marco T de Mello, Natália Elias, Francisco A H Fonseca, Deborah C L Masquio, Patrícia L da Silva, Flavia C Corgosinho, Lian Tock, Lila M Oyama, Sergio Tufik, and Ana R Dâmaso.
• Post Graduate Program of Nutrition, Universidade Federal de São Paulo, Rua Marselhesa, 650 - Vila Clementino, São Paulo 04020-050, Brazil. Electronic address: ana.damaso@unifesp.br.
• J Clin Lipidol. 2014 May 1;8(3):265-72.

BackgroundObesity is associated with several cardiovascular risk factors, including nonalcoholic fatty liver disease (NAFLD). These risk factors can induce changes in the arteries such as an increase in the carotid intima-media thickness (cIMT), which contributes to the early development of atherosclerosis.ObjectiveTo determine whether NAFLD is associated with an atherogenic lipid profile, inflammatory markers, or cIMT in obese adolescents and to compare the effects of therapeutic lifestyle changes in NAFLD and non-NAFLD groups.MethodsA total of 79 obese adolescents were divided into two groups: 33 NAFLD and 46 non-NAFLD. They were submitted to an interdisciplinary therapy involving diet exercise and psychological support during the course of 1 year. The cIMT and estimates of fat mass (liver, intra-abdominal, and subcutaneous) were determined ultrasonographically. Body composition, glucose, lipid profile, and adipokines were analyzed before and after the therapy.ResultsAt baseline, only in the NAFLD group was the homeostasis model assessment of insulin resistance positively correlated with cIMT and triglyceride/high-density lipoprotein cholesterol ratio. Therapy was associated with an increase in adiponectin concentrations and reduced visceral fat, cIMT, leptin, and plasminogen activator inhibitor-1 concentrations, as well as the ratios of total cholesterol/high-density lipoprotein cholesterol and triglycerides/high-density lipoprotein cholesterol in both groups. Only in the non-NAFLD group did therapy result in a reduction in the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and increased high-density lipoprotein cholesterol concentration.ConclusionsIn obese adolescents, NAFLD is associated with cardiovascular risk factors and inflammatory markers of atherosclerosis that were positively correlated with cIMT only in the NAFLD group. Nevertheless, the strength of the present study is that the interdisciplinary therapy effectively improved cIMT and other proinflammatory adipokines in both groups.Copyright © 2014 National Lipid Association. Published by Elsevier Inc. All rights reserved.

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