Risk for Nonalcoholic Fatty Liver Disease in Young Adults Born Preterm

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome. Accelerated catch-up in weight during infancy in subjects born at full term has been associated with increased risk for NAFLD in adulthood, but this association has not been studied in subjects born preterm. Methods: In 162 young adults born at a gestational age <36 weeks, we assessed the associations between fatty liver index (FLI, 0-100) and birth weight standard deviation score and first-year weight gain. We performed comparisons between subjects with and without accelerated catch-up in weight in the first year after term age. An FLI score was assigned to each participant to determine the clinical relevance, and regression analyses were performed. Results: Accelerated weight gain in the first 3 months after term age was associated with FLI as a continuous variable, whereas gestational age and low birth weight were not. Of the subjects with accelerated catch-up in weight-for-length after term age, 7.3% had a high FLI at the age of 21 years, whereas none of the subjects without accelerated catch-up in weight had a high FLI. Conclusion: Our study shows that accelerated weight gain after term age is associated with an increased risk of developing NAFLD in young adults born preterm.

Exacerbation of liver steatosis following exposure to famine and overnutrition

“…The results of other famine studies were consistent with ours . There is also compelling evidence indicating that people who were stunted during infancy and childhood or who had low birth weight but subsequently had a continuous high‐fat diet (HFD) had higher susceptibility to fatty liver in later life . We call this a feast after famine model, which may reflect the high prevalence of NAFLD in China under their special nutrition history.…”

Indicators of fetal growth and adult liver enzymes: the Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study

“…Another study found that accelerated weight gain in infancy was associated with FLI but LBW and gestational age were not, but this study was limited to a young adults born preterm. 13 Support for the hypotheses that both low birthweight and high birthweight are associated with liver fat can be found in the animal literature. Higher-fat diets have been associated with both increased and decreased weight and corresponding adverse effects on the liver.…”

“…Late PTB was associated with higher ALT, AST and FLI (though not GGT) values in another study; 12 the majority of the PTB in our study were late, but the mean differences in both of our cohorts are much smaller than found in this previous study. Another study found that accelerated weight gain in infancy was associated with FLI but LBW and gestational age were not, but this study was limited to a young adults born preterm 13 …”

“…9,10 Two studies have considered preterm birth (PTB): in the preterm birth and early life programming of adult health and disease (ESTER) study, Finnish adults who were born preterm had higher risk of fatty liver index [FLI; an index combining information on triglycerides, body mass index (BMI), GGT, and waist circumference 11 ] >30, and to have higher overall ALT and AST levels, but no difference in GGT, 12 while a small Dutch study found that accelerated weight gain in infancy was associated with FLI, whereas birthweight and gestational age were not. 13 The question of the relationship between birthweight and liver enzymes thus remains an open question, suggesting that further research is needed. Two opposing hypotheses could be put forth on the relationship between birthweight and adult FLD.…”

“…In addition, differences by sex have been reported, with at least one study suggesting an inverse association between birthweight and adult GGT/ALT in women, but potentially a direct association in men 9 10 Two studies have considered preterm birth (PTB): in the preterm birth and early life programming of adult health and disease (ESTER) study, Finnish adults who were born preterm had higher risk of fatty liver index [FLI; an index combining information on triglycerides, body mass index (BMI), GGT, and waist circumference 11 ] >30, and to have higher overall ALT and AST levels, but no difference in GGT, 12 while a small Dutch study found that accelerated weight gain in infancy was associated with FLI, whereas birthweight and gestational age were not 13 …”