A study of occurrence of non-alcoholic steatohepatitis in children with obesity and overweight

S. Patil, Kumar Angadi, Meghana Somasundara
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Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and its increasingprevalence is associated with a concomitant rise in obesity. Anthropometric measurements and non-invasive tests (liver function tests and USG abdomen) help in early recognition of non-alcoholic steatohepatitis (NASH) and reduce consequent morbidity and mortality. Aim: This study aims to study the occurrence of NASH in obese and overweight children and to derive the correlation of NASH with clinical and biochemical parameters in overweight and obese children. Methods: This hospital-based prospective study included children (age?18 years) who met the inclusion criteria. Diagnosis of NASH was based on the USG abdomen. Measurements included anthropometry, ultrasonography, fasting glucose, alanine aminotransferase (ALT), lipid profile and additional parameters of blood pressure, fasting insulin, and homeostatic model assessment of insulin resistance (HOMA-IR). The variables were compared between children with and without NASH. Results: A total of 146 patients (female: 51.4%, male: 48.6%) were enrolled in the study. The most common age group affected was 11–18 years (50.7%) followed by 6–10 years (43.2%) and <5 years (6.2%). The occurrence of NASH in the study group was 63% of obese and overweight children. Mean weight, body mass index (BMI), waist circumference, waist-hip ratio, blood pressure (BP), serum glutamic-pyruvic transaminase (SGPT), fasting insulin level, and HOMA-IR were significantly higher in children with NASH. There was a significant association between SGPT and NASH. Elevated SGPT of 79.3% and 1.9% were observed among the subjects with and without NASH, respectively. Conclusion: Anthropometric indices and biochemical parameters were more elevated in the NASH group showing its direct correlation with hepatic steatosis.
肥胖和超重儿童发生非酒精性脂肪性肝炎的研究
背景:非酒精性脂肪性肝病(NAFLD)是儿童中最常见的慢性肝病,其患病率的增加与肥胖的增加有关。人体测量和非侵入性检查(肝功能检查和腹部USG)有助于早期识别非酒精性脂肪性肝炎(NASH),并降低随之而来的发病率和死亡率。目的:本研究旨在研究肥胖和超重儿童NASH的发生情况,并得出超重和肥胖儿童NASH与临床及生化参数的相关性。方法:这项以医院为基础的前瞻性研究纳入儿童(年龄?18岁),符合纳入标准。NASH的诊断是基于USG腹部。测量包括人体测量、超声检查、空腹血糖、谷丙转氨酶(ALT)、血脂和血压的附加参数、空腹胰岛素和胰岛素抵抗的稳态模型评估(HOMA-IR)。比较了NASH患儿和非NASH患儿之间的变量。结果:共纳入146例患者,其中女性占51.4%,男性占48.6%。最常见的年龄组为11-18岁(50.7%),其次为6-10岁(43.2%)和<5岁(6.2%)。在研究组中,肥胖和超重儿童的NASH发生率为63%。NASH患儿的平均体重、体重指数(BMI)、腰围、腰臀比、血压(BP)、血清谷丙转氨酶(SGPT)、空腹胰岛素水平和HOMA-IR均显著升高。SGPT与NASH之间存在显著关联。在NASH患者和非NASH患者中,SGPT分别升高79.3%和1.9%。结论:NASH组人体测量指标及生化指标升高,与肝脂肪变性有直接关系。
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