Approach to prevention and treatment of non-alcoholic fatty liver disease in children with obesity from the position of current international recommendations
Background. The article deals with the problem of preventing the development and treatment of non-alcoholic fatty liver disease (NAFLD) in children with obesity of the alimentary-constitutional type. The purpose of the work was to study the efficacy and safety of omega-3 polyunsaturated fatty acids (PUFAs) with vitamin E and a multiprobiotic complex enriched with vitamins for the prevention the development and progression of steatohepatosis. Materials and methods. In total, 55 children diagnosed with alimentary-constitutional obesity were followed-up. All patients were prescribed drug therapy with omega-3 PUFA Reytoil and the combined probiotic Breveluck (Lactobacillus helveticus R0052, Lactococcus lactis ssp. lactis R1058, Bifidobacterium longum R0175, Lactobacillus rhamnosus R0011, Bifidobacterium breve R0070, Streptococcus thermophilus R0083, Bifidobacterium bifidum R0071, Lactobacillus casei R0215, Lactobacillus plantarum R1012) against the background of lifestyle modification. Results. The course of NAFLD in most children had no characteristic clinical symptoms and severe cytolysis syndrome. Structural and functional changes in the liver with NAFLD can cause metabolic disorders with the formation of severe atherogenic dyslipidemia. A three-month treatment of NAFLD with omega-3 PUFA Reytoil and combined probiotic Breveluck showed a significant decrease in the activity of hepatic cytolytic enzymes and an improvement in the blood lipid spectrum. Conclusions. The prescription of omega-3 PUFAs in combination with strains of probiotic cultures with proven clinical efficacy in NAFLD on the background of lifestyle modification contributes to the effective prevention and treatment of this pathology in children.
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Skinner AC, Ravanbakht SN, Skelton JA, Perrin EM, Armstrong SC. Prevalence of Obesity and Severe Obesity in US Children, 1999-2016. Pediatrics. 2018 Mar;141(3). pii: e20173459. doi: 10.1542/peds.2017-3459.
Ogden CL, Carroll MD, Lawman HG, et al. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. JAMA. 2016 Jun 7;315(21):2292-9. doi: 10.1001/jama.2016.6361.
Araújo AR, Rosso N, Bedogni G, Tiribelli C, Bellentani S. Global epidemiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: What we need in the future. Liver Int. 2018 Feb;38 Suppl 1:47-51. doi: 10.1111/liv.13643.
Arrigo FG, Colletti A, Bellentani S. Nutraceutical Approach to Non-Alcoholic Fatty Liver Disease (NAFLD): The Available Clinical Evidence. Nutrients. 2018 Aug 23;10(9). pii: E1153. doi: 10.3390/nu10091153.
Vos MB, Abrams SH, Barlow SE, et al. NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the expert committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr. 2017 Feb;64(2):319-334. doi: 10.1097/MPG.0000000000001482.
Abaturov AE, Kryuchko TO, Krivusha EL, Poda OA. Efficacy of hepatoprotective therapy with the complex drug "Betargin" in children with non-alcoholic fatty liver disease. Sovremennaya pediatriya. 2018;3(91:102-110. (in Russian).
Kryuchko TO, Poda OA. Metabolic syndrome and nonalcoholic fatty liver disease in pediatric patients - what comes first? International Journal of Pediatrics, Obstetrics and Gynecology. 2015;7(1):25-33. (in Russian).
Koot BG, van der Baan-Slootweg OH, Vinke S, et al. Intensive lifestyle treatment for non-alcoholic fatty liver disease in children with severe obesity: inpatient versus ambulatory treatment. Int J Obes (Lond). 2016 Jan;40(1):51-7. doi: 10.1038/ijo.2015.175.
Wijarnpreecha K, Thongprayoon C, Edmonds PJ, Cheungpasitporn W. Associations of sugar- and artificially sweetened soda with nonalcoholic fatty liver disease: a systematic review and meta-analysis. QJM. 2016 Jul;109(7):461-466. doi: 10.1093/qjmed/hcv172.
Cicero AF, Reggi A, Parini A, Borghi C. Application of polyunsaturated fatty acids in internal medicine: beyond the established cardiovascular effects. Arch Med Sci. 2012 Nov 9;8(5):784-93. doi: 10.5114/aoms.2012.31613.
He XX, Wu XL, Chen RP, et al. Effectiveness of Omega-3 Polyunsaturated Fatty Acids in Non-Alcoholic Fatty Liver Disease: A Meta-Analysis of Randomized Controlled Trials. PLoS One. 2016 Oct 6;11(10):e0162368. doi: 10.1371/journal.pone.0162368.
Chen LH, Wang YF, Xu QH, Chen SS. Omega-3 fatty acids as a treatment for non-alcoholic fatty liver disease in children: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr. 2018 Apr;37(2):516-521. doi: 10.1016/j.clnu.2016.12.009.
Skrypnyk IN. Assessment of therapeutic approaches to the NASH treatment in Ukraine and its correlation with risk factors: results of the open multicentre prospective study DIREG_L_04443. Modern Gastroenterology. 2013;(70):64-70. (in Russian).
Vajro P, Mandato C, Licenziati MR, et al. Effects of Lactobacillus rhamnosus strain GG in pediatric obesity-related liver disease. J Pediatr Gastroenterol Nutr. 2011 Jun;52(6):740-3. doi: 10.1097/MPG.0b013e31821f9b85.
Friedewald WT, Levy RI, Fridrickson DS. Estimation of the concentration of lowdensity lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 Jun;18(6):499-502.
Tseng PH, Liu CJ, Kao JH, Shun CT, Chen PJ, Chen DS. Disease progression in a patient with nonalcoholic steatohepatitis. J Formos Med Assoc. 2008 Oct;107(10):816-21. doi: 10.1016/S0929-6646(08)60196-5.
Alisi A, Bedogni G, Baviera G, et al. Randomised clinical trial: the beneficial effects of VSL#3 in obese children with non-alcoholic steatohepatitis. Aliment Pharmacol Ther. 2014 Jun;39(11):1276-85. doi: 10.1111/apt.12758.
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