medigraphic.com

2015, Número 4

<< Anterior Siguiente >>

Anales de Radiología México 2015; 14 (4)


Aumento del grosor íntima-media carotídeo y esteatosis hepática en pacientes pediátricos con obesidad y anormalidades metabólicas

Contreras-Vázquez C, Rivera-Villanueva R, Ruiz-Ochoa D, Bocanegra-Kanagúsico A, Millán-Sánchez N, Moreno-Castillo E, León-Hernández S, Lugo-Álvarez I

Idioma: Español
Referencias bibliográficas: 63
Paginas: 395-410
Archivo PDF: 453.72 Kb.


RESUMEN

El estudio con ultrasonido del grosor íntima-media carotídeo cada vez cobra mayor importancia; su aumento se asocia con ateroesclerosis en adultos y en niños; también con esteatosis hepática no alcohólica.
Objetivo: determinar la asociación entre el aumento del grosor de íntima-media carotídeo y la esteatosis hepática en pacientes pediátricos con obesidad y anormalidades metabólicas.
Material y métodos: estudio observacional, transversal, de estratos internos en niños diagnosticados con sobrepeso y obesidad con edades de 6 a 16 años; se evaluaron grosor íntima-media carotídeo, esteatosis hepática, estudios de laboratorio y parámetros antropométricos.
Resultados: se observó una fuerte asociación entre la esteatosis hepática y el aumento del grosor íntima-media carotídeo. Los pacientes con esteatosis moderada tuvieron 2.36 veces más riesgo de grosor íntimamedia de 0.6-0.8 mm. En general, la combinación de medias de seis variables (peso, índice de masa corporal, masa grasa, porcentaje de grasa, colesterol y alanina-aminotransferasa) clasifica con exactitud 82% de los casos; con sensibilidad de 97.4, 80 y 100% para grosores íntima-media de 0.4-0.5, 0.7 y 0.8 mm, respectivamente; baja a 40% para grosores de 0.6 mm. Independientemente del grosor íntima-media los casos con esteatosis moderada tuvieron bajas concentraciones de colesterol HDL.
Conclusiones: peso, índice de masa corporal, masa grasa, porcentaje de grasa, colesterol y alanina-aminotransferasa son variables que permiten clasificar a qué grupo de grosor pertenece un niño; los valores altos se relacionan con mayor riesgo de esteatosis hepática y bajos de colesterol HDL.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Angulo P. Non alcoholic fatty liver disease. N Engl J Med. 2002; 346 (16): 1221-31, Matteoni CA, Younossi ZM, Gramlich T, et al. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology. 1999;116(6):1413-9.

  2. Bohte AE, van Werven JR, Bipat S, et al. The diagnostic accuracy of US, CT, MRI and 1H-MRS for the evaluation of hepatic steatosis compared with liver biopsy: a metaanalysis. Eur Radiol 2011;21:87–97.

  3. Lee SS, Park SH, Kim HJ, et al. Non-invasive assessment of hepatic steatosis: prospective comparison of the accuracy of imaging examinations. J Hepatol 2010;52:579–585.

  4. Mennesson N, Dumortier J, Hervieu V, et al. Liver steatosis quantification using magnetic resonance imaging: a prospective comparative study with liver biopsy. J Comput Assist Tomogr 2009;33:672–677.

  5. Meisamy S, Hines CD, Hamilton G, et al. Quantification of hepatic steatosis with T1-independent, T2-corrected MR imaging with spectral modeling of fat: blinded comparison with MR spectroscopy. Radiology 2011;258:767–775.

  6. Yokoo T, Bydder M, Hamilton G, et al. Nonalcoholic fatty liver disease: diagnostic and fat-grading accuracy of lowflip- angle multiecho gradient-recalled-echo MR imaging at 1.5 T. Radiology 2009;251:67–76.

  7. Yokoo T, Shiehmorteza M, Hamilton G, et al. Estimation of hepatic proton-density fat fraction by using MR imaging at 3.0 T. Radiology 2011;258:749–759.

  8. Idilman IS, Aniktar H, Idilman R, et al. Hepatic steatosis: quantification by proton density fat fraction with MR imaging versus liver biopsy. Radiology 2013;267:767–775.

  9. Seung S L, et al., Non-invasive assessment of hepatic steatosis: Prospective comparison of the accuracy of imaging examinations. Journal of Hepatology 2010 vol. 52 j 579–585.

  10. Duncan GE, Li SM, Zhou XH. Prevalence and trends of a metabolic syndrome phenotype among US adolescents, 1999-2000. Diabetes Care 2004;27:2438-43.

  11. Skilton MR, Moulin P, Serusclat A, Nony P, Bonnet F. A comparison of the NCEP-ATPIII, IDF and AHA/NHLBI metabolic syndrome definitions with relation to early carotid atherosclerosis in subjects with hypercholesterolemia or at risk of CVD: evidence for sex-specific differences. Atherosclesosis 2007;190:416-22.

  12. Croymans DM, Sanchez A, Barth JD, Roberts C. Carotid intima-media thickness, dietary intake, and cardiovascular phenotypes in adolescents: relation to metabolic syndrome. Metabolism Clinical and Experimental 2010;59:533-9.

  13. Hollander M, Hak AE, Koudstaal PJ, Bots ML, Grobbee DE, Hofman A et al. Comparison between measures of atherosclerosis and risk of stroke: the Rotterdam Study. Stroke 2003;34:2367-72.

  14. Järvisalo MJ, Jartti L, Näntö-Salonen K, Irjala K, Rönnemaa T, Hartiala JJ et al. Increased aortic intima-media thickness: a marker of preclinical atherosclerosis in high-risk children. Circulation 2001;104:2943-7.

  15. Woo KS, Chook P, Yu CW. Overweight in children is associated with arterial endothelial dysfunction and intima-media thickening. Int Obes Relat Metab Disord 2004;28:852-7.

  16. McGill HC, Mcmahan CA, Gidding SS. Preventing heart disease in the 21st century: implications of the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study. Circulation 2008;117:1216-2.

  17. Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics 2007;120(Suppl. 4):164–92.

  18. Kulaga Z, Rozdzynska A, Palczewska I, Grajda A, Gurzkowska B, Napieralska E, et al. Percentile charts of height, body mass and body mass index in children and adolescents in Poland — results of the OLAF study. Stand Med Pediatr 2010;7:690–700.

  19. Han JC, Lawlor DA, Kimm SYS. Childhood obesity — 2010: progress and challenges. Lancet 2010;375:1737–48.

  20. Singh GK, Kogan MD, van Dyck PC. Changes in state-specific childhood obesity and overweight prevalence in the United States from 2003 to 2007. Arch Pediatr Adolesc Med 2010;164:598–607.

  21. Daniels SR, Kelly AS. Pediatric severe obesity: time to establish serious treatments for a serious disease. Child Obes 2014;10:283–4.

  22. Khoury M, Manlhiot C, Dobbin S, Gibson D, Chahal N, Wong H, et al. Role of waist measures in characterizing the lipid and blood pressure assessment of adolescents classified by body mass index. Arch Pediatr Adolesc Med 2012;166:719–24.

  23. Qiang Zeng, Sheng-Yong Dong, Xiao-Nan Sun, Jing Xie, and Yi Cui. Percent body fat is a better predictor of cardiovascular risk factors than body mass index. Braz J Med Biol Res. 2012;45(7):591-600.

  24. Carpenter CL, Yan E, Chen S, Hong K, Arechiga A, Kim WS, Deng M, Li Z, Heber D. Body fat and body-mass index among a multiethnic sample of college-age men and women. J Obes 2013;2013:790654.

  25. Kobayashi J, Murano S, Kawamura I, Nakamura F, Murase Y, Kawashiri MA, Nohara A, Asano A, Inazu A, Mabuchi H.The relationship of percent body fat by bioelectrical impedance analysis with blood pressure, and glucose and lipid parameters. J Atheroscler Thromb. 2006;13(5):221-6.

  26. Jourdan C, Wühl E, Litwin M, Fahr K, Trelewicz J, Jobs K, et al. Normative values for intima-media thickness and distensibility of large arteries in healthy adolescents. J Hypertens 2005;23:1707-15.

  27. Ishizu T, Ishimitsu T, Yanagi H, Seo Y, Obara K, Moriyama N et al. Effect of age on carotid arterial intima-media thickness in childhood. Heart Vessels 2004;19:189-95.

  28. Jourdan C, Wühl E, Litwin M, Fahr K, Trelewicz J, Jobs K, et al. Normative values for intima-media thickness and distensibility of large arteries in healthy adolescents. J Hypertens 2005;23:1707-15.

  29. Khoury M, Manlhiot C, Dobbin S, Gibson D, Chahal N, Wong H, et al. Role of waist measures in characterizing the lipid and blood pressure assessment of adolescents classified by body mass index. Arch Pediatr Adolesc Med 2012;166:719–24.

  30. Cunningham SA, Kramer MR, Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med 2014; 370:403–11.

  31. Pacifico L, Cantisani V, Ricci P, et al. Nonalcoholic fatty liver disease and carotid atherosclerosis in children. Pediatr Res 2008;63:423–7.

  32. Demircioğlu F, Koçyiğit A, Arslan N, Cakmakçi H, Hizli S, Sedat AT. Nonalcoholic fatty liver disease and carotid artery atherosclerosis in children and adults: a meta-analysis. J Pediatr Gastroenterol Nutr. 2008;47(1):68-75.

  33. Minino AM, Heron MP, Murphy SL, Kochanek KD. Deaths: final data for 2004. Natl Vital Stat Rep 2007;55: 1-119.

  34. Mittelman SD, Gilsanz P, Mo AO, Wood J, Dorey F, Gilsanz V. Adiposity Predicts Carotid Intima-Media Thickness in Healthy Children and Adolescents. J Pediatr 2010;156:592-7.

  35. Rohani M, Jogestrand T, Ekberg M, van der Linden J, Källner G, Jussila R et al. Interrelation between the extent of atherosclerosis in the thoracic aorta, carotid intima-media thickness and the extent of coronary artery disease. Atherosclerosis 2005;179:311-6.

  36. Speiser PW, Rudolf MC, Anhalt H, et al. Childhood obesity. J Clin Endocrinol Metab 2005;90:187187.

  37. Speiser PW, Rudolf MC, Anhalt H, et al. Childhood obesity. J Clin Endocrinol Metab 2005;90:1871

  38. Huang JS, Barlow SE, Quiros-Tejeira RE, et al. Childhood obesity for pediatric gastroenterologists. J Pediatr Gastroenterol Nutr 2013;56:99.

  39. Franzese A, Vajro P, Argenziano A, et al. Liver involvement in obese children. Ultrasonography and liver enzyme levels at diagnosis and during follow-up in an Italian population. Dig Dis Sci 1997;42:1428.

  40. Tazawa Y, Noguchi H, Nishinomiya F, Takada G. Serum alanine aminotransferase activity in obese children. Acta Paediatr 1997;86:238.

  41. Kinugasa A, Tsunamoto K, Furukawa N, et al. Fatty liver and its fibrous changes found in simple obesity of children. J Pediatr Gastroenterol Nutr 1984;3:408.87.

  42. Franzese A, Vajro P, Argenziano A, et al. Liver involvement in obese children. Ultrasonography and liver enzyme levels at diagnosis and during follow-up in an Italian population. Dig Dis Sci 1997;42:1428

  43. Vajro P, Fontanella A, Perna C, et al. Persistent hyperaminotransferasemia resolving after weight reduction in obese children. J Pediatr 1994;125:239..

  44. [Franzese A, Vajro P, Argenziano A, et al. Liver involvement in obese children. Ultrasonography and liver enzyme levels at diagnosis and during follow-up in an Italian population. Dig Dis Sci 1997;42:1428.

  45. Radetti G, Kleon W, Stuefer J, Pittschieler K. Non-alcoholic fatty liver disease in obese children evaluated by magnetic resonance imaging. Acta Paediatr 2006;95:833

  46. Shannon A, Alkhouri N, Carter-Kent C, et al. Ultrasonographic quantitative estimation of hepatic steatosis in children With NAFLD. J Pediatr Gastroenterol Nutr 2011;53:190.

  47. Strauss RS, Barlow SE, Dietz WH. Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents. J Pediatr 2000;136:727.

  48. Tominaga K, Kurata JH, Chen YK, et al. Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey. Dig Dis Sci 1995;40:2002.

  49. Chan DF, Li AM, Chu WC, et al. Hepatic steatosis in obese Chinese children. Int J Obes Relat Metab Disord 2004;28:1257.

  50. Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983;67:968.

  51. Berenson GS, Srinivasan SR, Bao W, et al. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 1998;338:1650.

  52. McGill HC Jr, McMahan CA, Zieske AW, et al. Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth. The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Arterioscler Thromb Vasc Biol 2000;20:1998.

  53. Juonala M, Viikari JS, Rönnemaa T, et al. Associations of dyslipidemias from childhood to adulthood with carotid intima-media thickness, elasticity, and brachial flowmediated dilatation in adulthood: the Cardiovascular Risk in Young Finns Study. Arterioscler Thromb Vasc Biol 2008;28:1012.

  54. Mahoney LT, Burns TL, Stanford W, et al. Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. J Am Coll Cardiol 1996;27:277.

  55. Li S, Chen W, Srinivasan SR, et al. Childhood cardiovascular risk factors and carotid vascular changes in adulthood: the Bogalusa Heart Study. JAMA 2003;290:2271.

  56. Raitakari OT, Juonala M, Kähönen M, et al. Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA 2003;290:2277.

  57. Frontini MG, Srinivasan SR, Xu J, et al. Usefulness of childhood non-high density lipoprotein cholesterol levels versus other lipoprotein measures in predicting adult subclinical atherosclerosis: the Bogalusa Heart Study. Pediatrics 2008;121:924.

  58. Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics 2011;128(Suppl 5):S213.

  59. Brown OW, Hardin A, Lessin HR, et al. 2014 recommendations for pediatric preventive health care. Pediatrics 2014;133:568.

  60. Roberts CK, Barnard RJ. Effects of exercise and diet on chronic disease. J Appl Physiol 2005;98:3-30.

  61. Aggoun Y. Obesity, metabolic syndrome, and cardiovascular disease. Pediatr Res 2007;61:653-9.

  62. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet 2005; 365: 1415-28.

  63. Mittelman SD, Gilsanz P, Mo AO, Wood J, Dorey F, Gilsanz V. Adiposity Predicts Carotid Intima-Media Thickness in Healthy Children and Adolescents. J Pediatr 2010;156:592-7.




2020     |     www.medigraphic.com