Nonalcoholic Fatty Liver Disease in Children with Excess of Weight
Résumé
Rationale:
Obesity in children is a public health problem. Obesity can be complicated by liver damage. The aim of our study was to investigate the nonalcoholic fatty liver disease (NAFLD) in children with excess of weight and factors associated with NAFLD.
Methods:
Children with overweight and obesity had measures of body mass index (BMI), waist circumference (WC), blood pressure (BP), fasting serum glucose and lipids (total cholesterol, HDL-c, LDL-c and triglycerides) and hepatic function (ASAT, ALAT, γ GT). The NAFLD was researched with ultrasound and predictive score of NAFLD was calculated : hepatic steatosis index (HSI). Metabolic syndrome was diagnosed with WC, BP, serum glucose, HDL-c and triglycerides. Statistical analysis used Student ’ s t tests, Chi2 and logistic regression.
Results:
Seventy-six children were included, 46% of males with a mean age of 11.3 ± 3.4 years. The mean BMI was of 29.1 ± 5.9 kg/m2 and 77.6% of children were obese. The serum glucose and lipid levels were no different between overweight and obese children. In contrast, the ALAT/ASATratio
was higher in obese (1.0 ± 0.4 vs. 0.8 ± 0.3, p = 0.02). The HSI score was higher in obese (40.0 ± 7.0 vs. 30.2 ± 6.8, p < 0.0001). With ultrasound NAFLD was found in 38.2%, 43.4% in obesity. Metabolic syndrome was found in 50.0% in children with NAFLD.
The HSI was positive in 92.0% in children with NAFLD. WC (OR = 1.09 [95% CI: 1.09 – 1.16]; p = 0.0034), systolic BP(OR = 1.06 [95% CI: 1.01–
1.12]; p = 0.03) and triglycerides (OR = 1.03 [95% CI 1.001–1.05]; p = 0.016) were positively associated with NAFLD.
Conclusion:
Over one third of children had a NAFLD. NAFLD was two time more present in obesity. Criteria of metabolic syndrome (WC, systolic BP and triglyceride) were positively associated with NAFLD. Considering the risk of progression, it seems essential to follow these children mainly in case of obesity with metabolic syndrome and continue this follow up in adulthood