2021, Number 2
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Aten Fam 2021; 28 (2)
Ultrasonography and Functional Hepatic Alterations in Obese Children and Adolescents
González PB, Salas FR, Yáñez CBM, Hernández CRG, Reséndiz GE, Áspera CT
Language: Spanish
References: 31
Page: 82-88
PDF size: 166.33 Kb.
ABSTRACT
Objective: To determine the ultrasonography
and liver functional alterations
in obese children and adolescents.
Methods: non-experimental, analytical,
cross-sectional study carried out in
children and adolescents with obesity
from five to seventeen years of age. The
sample was divided into two groups,
one with the presence of non-alcoholic
fatty liver disease (nafld) (group 1)
and the other with normal liver (group
2), determined by ultrasonography.
Anthropometry, body composition
and serum level measurements were
performed to establish a biochemical
and functional liver profile. Differences
between groups were analyzed
by Student’s t-test, p‹0.05.
Results: a
total of 59 participants were studied, of
which 54.2% (n=32) were female and
45.8% (n=27) male. The average age
of the population studied was 10.05
± 2.5 years. Group 1 consisted of a
total of 72.9% of patients (n=43), and
group 2 consisted of 27.1% (n=16). The
findings showed alterations in serum
levels, biochemical profile and liver
functionality. Fasting transaminases
and insulin were significantly higher
in group 1 patients than in group 2
(p‹0.05). A higher insulin resistance
(p=0.000) was also observed in group
1.
Conclusions: there were alterations
in serum levels, biochemical profile and
hepatic functionality. Ultrasound and
liver function tests should be part of the
initial evaluation for early identification
of this pathology in obese infants.
REFERENCES
Salazar Preciado LL, Larrosa Haro A, Chávez Palencia C, Lizárraga Corona E. Disminución en los indicadores antropométricos de adiposidad en niños escolares como indicador de la transición nutricia en México. Rev Med Inst Mex Seguro Soc. 2017;55(2):150-155.
Shamah Levy T, Cuevas Nasu L, Gaona Pineda EB, Gómez Acosta LM, Morales Rúan MDC, Hernández Ávila M, Rivera Dommarco JÁ. Sobrepeso y obesidad en niños y adolescentes en México, actualización de la Encuesta Nacional de Salud y Nutrición de Medio Camino 2016. Salud Publica Mex. 2018;60(3):244-253.
Kinlen D, Cody D, O’Shea D. Complications of obesity. QJM. 2018;111(7):437-443.
Betancourt Garcia MM, Arguelles A, Montes J, Hernández A, Singh M, Forse RA. Pediatric Nonalcoholic Fatty Liver Disease: the Rise of a Lethal Disease Among Mexican American Hispanic Children. Obesity Surgery 2017;27(1):236-244.
Fleet SE, Lefkowitch JH, Lavine JE. Current Concepts in Pediatric Nonalcoholic Fatty Liver Disease. Gastroenterology Clinics of North America. 2017;46(2):217-231.
Schwimmer JB, Deutsch R, Kahen T, Lavine JE, Stanley C, Behling C. Prevalence of Fatty Liver in Children and Adolescents. Pediatrics 2006;118(4):1388-1393.
Bojórquez Ramos MC. Enfermedad por hígado graso no alcohólico en pediatría. Rev Med Inst Mex Seguro Soc. 2014;52(Suppl 1):S110-S114.
Contreras Vázquez C, Rivera Villanueva R, Ruiz Ochoa D, Bocanegra Kanagúsico A, Millán Sánchez N, Moreno Castillo E, Lugo Álvarez I. Aumento del grosor íntima-media carotídeo y esteatosis hepática en pacientes pediátricos con obesidad y anormalidades metabólicas. Anales de Radiología México 2015;14: 395-410.
Koot BGP, Nobili V. Screening for non-alcoholic fatty liver disease in children: do guidelines provide enough guidance? Obesity Reviews 2017;18(9):1050-1060.
Perumpail BJ, Khan MA, Yoo ER, Cholankeril G, Kim D, Ahmed A. Clinical epidemiology and disease burden of nonalcoholic fatty liver disease. World J Gastroenterol. 2017;9327(17):8263-8276.
Daar G, Serin Hİ, Ede H, Hüsrevşahi H. Association between the corrected QT interval, carotid artery intima-media thickness, and hepatic steatosis in obese children. Anatol J Cardiol. 2016;16(7):524-528.
Akcam M, Boyaci A, Pirgon O, Koroglu M, Dundar BN. Importance of the liver ultrasound scores in pubertal obese children with nonalcoholic fatty liver disease. Clinical Imaging 2013;37(3):504-508.
Schlieske C, Denzer C, Wabitsch M, Oeztuerk S, Mason RA, Thiere D, Kratzer W. Sonographically measured suprailiac adipose tissue is a useful predictor of non-alcoholic fatty liver disease in obese children and adolescents. Pediatric Obesity 2015;10(4):260-266.
Center for Disease Control and Prevention (CDC). USA: National Center for Health Statistics, 2008. Prevention and Health Promotion. 2000. [Internet]. [Consultado 2019 Ene 14] Disponible en: http://www.cdc.gov/growthcharts
National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114 (Suppl 1. 4th Report):555-576.
American Diabetes Association. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes. ADA. Diabetes Care. 2020;43(Suppl 1):S14-S31.
Calzada León R, Dorantes Álvarez L, Barrientos Pérez M. Recomendaciones de la Sociedad Mexicana de Endocrinología Pediátrica, A.C. para el tratamiento de obesidad en niños y adolescentes. Acta Pediátrica de México. 2006;27(5):279-86.
Rinella ME. Nonalcoholic fatty liver disease: a systematic review. JAMA. 2015;313(22):2263-73.
Chalasani N, Younossi Z, Lavine JE, Diehl AM, Brunt EM, Cusi K, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology. 2012;142(7):1592-609.
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(9):2002-2009.
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(7):1428-1432.
Villanueva Ortega E, Garcés Hernández MJ, Herrera Rosas A, et al. Gender-specific differences in clinical and metabolic variables associated with NAFLD in a Mexican pediatric population. Ann Hepatol. 2019;18(5):693-700.
Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806-814.
Temple JL, Cordero P, Li J, Nguyen V, Oben JA. A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence. Int J Mol Sci. 2016;17(6):947.
Seo YG, Kim JH, Kim Y, et al. Validation of body composition using bioelectrical impedance analysis in children according to the degree of obesity. Scand J Med Sci Sports. 2018;28(10):2207-2215.
Fishbein MH, Miner M, Mogren C, Chalekson J. The spectrum of fatty liver in obese children and the relationship of serum aminotransferases to severity of steatosis. J Pediatr Gastroenterol Nutr. 2003;36(1):54-61.
Goh GB, Pagadala MR, Dasarathy J, et al. Age impacts ability of aspartate-alanine aminotransferase ratio to predict advanced fibrosis in nonalcoholic Fatty liver disease. Dig Dis Sci. 2015;60(6):1825-1831.
Maximos M, Bril F, Portillo Sanchez P, et al. The role of liver fat and insulin resistance as determinants of plasma aminotransferase elevation in nonalcoholic fatty liver disease. Hepatology. 2015;61(1):153-160.
Fracanzani AL, Valenti L, Bugianesi E, et al. Risk of severe liver disease in nonalcoholic fatty liver disease with normal aminotransferase levels: a role for insulin resistance and diabetes. Hepatology. 2008;48(3):792-798.
Harlow KE, Africa JA, Wells A, et al. Clinically Actionable Hypercholesterolemia and Hypertriglyceridemia in Children with Nonalcoholic Fatty Liver Disease. J Pediatr. 2018;198:76-83.e2.
Kang BK, Kim M, Shin SJ, Kim YJ. Correlation of Clinical and Histopathologic Parameters with Ultrasonographic Grades in Pediatric Non- Alcoholic Fatty Liver Disease. J Korean Med Sci. 2019;34(47):e298. González-Pérez B. y cols. Aten Fam. 2021;28(2):82-88. http://dx.doi.org/10.22201/fm.14058871p.2021.2.78795
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