This is a study to investigate genetic predisposition to hepatic steatosis and the expression of gluconeogenic and lipogenic genes in livers of obese children and adolescents. Hypothesis 1: Common variants recently associated with variation in plasma TG levels identified in Genome Wide Association Studies (GWAS) (such as GCKR, PNPLA3) can affect accumulation of fat and subsequent development of Non Alcoholic Fatty Liver Disease (NAFLD). Gene variants act in additive or synergistic manner with progressive liver fat accumulation per additional risk allele. Hypothesis 2: With increase in hepatic fat content NASH and fibrosis will increase. Furthermore, expression of lipogenic markers (SREBP1c) will increase.
To establish a cohort of obese youths to prospectively analyze potential factors (genetic and nutritional factors) that might affect the expression and progression of NAFLD. This study will determine genetic markers and their ability to convey susceptibility to NAFLD in obese children and adolescents. Furthermore, potential mechanisms that might contribute to the accumulation of hepatic Triglyceride (TG) accumulation will be, for the first time, assessed by genotyping. Additionally, we will examine the presence of intestinal microbiome in the development of fatty liver through stool collection.
Study Type
OBSERVATIONAL
Enrollment
381
oral glucose tolerance test
genotyping to look for risk alleles
magnetic resonance imaging scan of abdomen and liver - abdominal and liver mri
stool sample taken to investigate metabolites
liver biopsy to examine for cellular change and steatosis
Yale University
New Haven, Connecticut, United States
gene expression
gene mutation allele variation identification measure via gene extraction
Time frame: Baseline
hepatic fat content
Abdominal MRI to measure liver fat and subcutaneous and visceral fat ratio done at baseline and 2 year follow up
Time frame: 2 years
glucose tolerance
glucose tolerance status measured by 3 hour oral glucose tolerance test done at baseline and 2 year follow up
Time frame: 2 years
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