Determinants of intrahepatocellular lipid (IHCL) in healthy term infants
Author(s)
Murgasova, Dominika
Type
Thesis
Abstract
Background: In adults intrahepatocellular lipid (IHCL) is a strong correlate of insulin
resistance and other components of the metabolic syndrome. Knowledge about
IHCL in healthy term infants is very limited.
Aim: The aim of this study was to describe the variation in IHCL in healthy term
neonates and identify determinants of deposition. My secondary aim was to explore
the relationship between IHCL and body adiposity.
Methods: With Research Ethics approval and informed written parent consent I
employed Magnetic Resonance Imaging and Hepatic Spectroscopy during natural
sleep in healthy term neonates. Using SPSS 17.0 birth weight, gestational size,
gender, mode of delivery, maternal BMI and diabetes were analysed singly in
relation to IHCL (expressed as lipid CH2/water ratio) and performing analysis of
covariance.
Results: I have studied 52 male and 56 female infants, born by vaginal delivery (VD,
n=72), in-labour Caesarean Section (CS, n=18) and pre-labour CS (n=18). Maternal
Body Mass Index (BMI) ranged from 17 to 41. IHCL ranged from 0 to 17.27, median
0.48. Postnatal age was positively correlated with IHCL. There was a trend toward
higher IHCL in males. In infants born by pre-labour CS, there was a statistically
significant positive effect of maternal BMI on IHCL, with no effect in the other two
groups. Birth weight, gestational size and maternal diabetes did not show any effect
on IHCL. There was a positive correlation between IHCL and total adipose tissue (AT), superficial and deep subcutaneous AT, after adjusting for birth weight and
gender.
Conclusion: IHCL content in healthy term babies is variable and appears to
increase with postnatal age. A new suggestion is that VD may activate pathways
protecting against IHCL accumulation that is driven by increasing maternal BMI. The
strong correlation between deep subcutaneous AT and IHCL points to the potential
role in metabolic programming.
resistance and other components of the metabolic syndrome. Knowledge about
IHCL in healthy term infants is very limited.
Aim: The aim of this study was to describe the variation in IHCL in healthy term
neonates and identify determinants of deposition. My secondary aim was to explore
the relationship between IHCL and body adiposity.
Methods: With Research Ethics approval and informed written parent consent I
employed Magnetic Resonance Imaging and Hepatic Spectroscopy during natural
sleep in healthy term neonates. Using SPSS 17.0 birth weight, gestational size,
gender, mode of delivery, maternal BMI and diabetes were analysed singly in
relation to IHCL (expressed as lipid CH2/water ratio) and performing analysis of
covariance.
Results: I have studied 52 male and 56 female infants, born by vaginal delivery (VD,
n=72), in-labour Caesarean Section (CS, n=18) and pre-labour CS (n=18). Maternal
Body Mass Index (BMI) ranged from 17 to 41. IHCL ranged from 0 to 17.27, median
0.48. Postnatal age was positively correlated with IHCL. There was a trend toward
higher IHCL in males. In infants born by pre-labour CS, there was a statistically
significant positive effect of maternal BMI on IHCL, with no effect in the other two
groups. Birth weight, gestational size and maternal diabetes did not show any effect
on IHCL. There was a positive correlation between IHCL and total adipose tissue (AT), superficial and deep subcutaneous AT, after adjusting for birth weight and
gender.
Conclusion: IHCL content in healthy term babies is variable and appears to
increase with postnatal age. A new suggestion is that VD may activate pathways
protecting against IHCL accumulation that is driven by increasing maternal BMI. The
strong correlation between deep subcutaneous AT and IHCL points to the potential
role in metabolic programming.
Date Issued
2011
Date Awarded
2012-06
Copyright Statement
Attribution NoDerivatives 4.0 International Licence (CC BY-ND)
Advisor
Modi, Neena
Uthaya, Sabita
Sponsor
Chelsea and Westminster Hospital NHS Foundation Trust
Publisher Department
Medicine
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Medicine (Research) MD (Res)