LAUSR

Obesity, insülin resistance (IR) and non-alcoholic fatty liver disease (NAFLD) are the major components of the metabolic syndrome. On the other hand, it is known that primer hypolipidemia is associated with increased prevalence of NAFLD. We evaluated the associations of IR and NAFLD with lipid metabolism parameters in 357 obese children and adeloscents (199 girls, 158 boys) from their hospital records. The LDL-C levels were compared to the reference LDL-C levels according to age and sex. The patients were divided into three groups according to the serum levels of LDL-C; Groups 1, 2, 3 consisted of hypolipidemic patients (n=61), normolipidemic patients (n=135) and hyperlipidemic patients (n=161), respectively. HOMA-IR above 3.42 was defined as IR. Body mass index were not different among these groups (p > 0.05). The frequency of NAFLD was 44.5% in the entire study group and were 52%, 44.7% and 41.4% in the Groups 1, 2, 3, respectively. The frequency of NAFLD were not different among these three groups (p > 0.05). In NAFLD patients, HDL-C levels were lower than in patients without NAFLD (p > 0.01) and negatively correlated with ALT levels (r = −0.1, p<0.05). In patients with IR (n=172), the frequency of NAFLD and triglyceride levels were higher and HDL-C levels were lower than in patients without IR (n=178). The frequency of IR were not different among the Groups 1, 2 and 3 (p > 0.05). It is found out that hypolipidemic obese patients, clinically not given much attention, have NAFLD at least as frequent as hyperlipidemic patients do. On the other hand, obese patients with IR and NAFLD have atherogenic profile; high trygliyceride and low HDL-C levels. Low HDL-C levels may be related with also hepatosteotitis in the NAFLD. Therefore, abnormalities in lipid metabolism are significant contributers of obesity and associated co-morbidities.