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Observational Study
. 2022 Mar 7;12(1):3690.
doi: 10.1038/s41598-022-07749-5.

Liver fat in adult survivors of severe acute malnutrition

Debbie S Thompson  1 , Tamika Y N Royal-Thomas  2 , Ingrid A Tennant  3   4 , Deanne P Soares  4 , Christopher D Byrne  5   6 , Terrence E Forrester  7 , Peter D Gluckman  8 , Michael S Boyne  3   9
Affiliations
Observational Study

Liver fat in adult survivors of severe acute malnutrition

Debbie S Thompson et al. Sci Rep. .

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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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Regression of mean liver attenuation against SAM phenotype (adjusted for age, sex and birth weight) in 88 SAM survivors. The mean liver attenuation + SD as bars in Hounsfield units (HU) is shown for adult survivors of oedematous malnutrition and severe wasting.
Figure 2
Figure 2
Regression of mean liver attenuation against birth weight (adjusted for age, sex and SAM phenotype) in 88 SAM survivors.
See this image and copyright information in PMC

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