Criteria for the progression of steatohepatosis in obese adolescents with signs of metabolic syndrome
Background. To date, obesity in adolescents is a serious problem, which is caused by the prevalence of this pathology, especially in developed countries, and the possible consequences in the future, in particular, metabolic syndrome. It was believed that metabolic syndrome is diagnosed in middle-aged people and in the elderly, but modern studies suggest that this pathology is increasingly manifested in adolescents, and the liver is a key organ of the pathogenesis of all metabolic disorders. Therefore, the study, which aims to determine the algorithm for the progression of steatohepatosis in obese adolescents with signs of metabolic syndrome, is relevant. Materials and methods. The study included 226 obese patients aged 12–18 years. To assess the functional state of the liver, clinical, laboratory and instrumental methods of research were used. The homeostasis model assessment was used as a criterion for insulin resistance. Also, serum levels of fibronectin, type IV collagen, N-terminal propeptides and C-terminal telopeptides of type I collagen were evaluated. To determine the criteria for the diagnosis of steatohepatosis in adolescents, Wald-Genkin procedure was used. Results. The results of basic researches (laboratory and instrumental) demonstrate the presence of impaired liver function in obese adolescents, which manifest themselves in the form of fatty liver disease. The revealed atherogenic dyslipidemia, presence of insulin resistance, abdominal obesity make it possible to determine the risk groups for the development of metabolic syndrome among adolescents. The diagnostic value of biochemical markers of fibrosis in non-alcoholic fatty liver disease was studied. The developed algorithm for the early diagnosis of steatohepatosis in obese adolescents confirmed its diagnostic value and reliability, which will contribute to the timely treatment of the disease and the prevention of complications. Conclusions. In the future, the use of the developed algorithm will improve the efficiency of early diagnosis of fatty liver disease, as well as the treatment and preventive measures.
Full Text:PDF (Українська)
Stepanov YuM, Abaturov OYe, Zavgorodnya NYu, Skirda IYu. Non-alcoholic fatty liver disease in children: a modern perspective on diagnosis and treatment (I part). Gastroenterologia. 2015;(56):99-107. doi: 10.22141/2308-2097.2.56.2015.81504.
Della Corte C, Alisi A, Saccari A, De Vito R, Vania A, Nobili V. Nonalcoholic fatty liver in children and adolescents: an overview. J Adolesc Health. 2012 Oct;51(4):305-12. doi: 10.1016/j.jadohealth.2012.01.010.
Stepanov YuM, Abaturov OYe, Zavgorodnya NYu, Skirda IYu. Non-alcoholic fatty liver disease in children: a modern perspective on diagnosis and treatment (II part) Gastroenterologia. 2015;(57):122-131. doi: 10.22141/2308-2097.3.57.2015.81535.
Ivashkin VT. Diagnosis and treatment of non-alcoholic fatty liver disease. Moskow: MEDpress-inform; 2012. 32 p.
Spreghini N, Cianfarani S, Spreghini MR, et al. Oral glucose effectiveness and metabolic risk in obese children and adolescents. Acta Diabetol. 2019 Aug;56(8):955-962. doi: 10.1007/s00592-019-01303-y.
Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease. Practice guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Am J Gastroenterol. 2012 Jun;107(6):811-26. doi: 10.1038/ajg.2012.128.
Fang Y, Ma Y, Mo D, et al. Methodology of an exercise intervention program using social incentives and gamification for obese children. BMC Public Health. 2019 Jun 3;19(1):686. doi: 10.1186/s12889-019-6992-x.
Barclay L, Desiree L. Waist-to-height ratio may predict cardiometabolic risk in normal-weiht children CME. BMC Pediatr. 2010;10:73-78.
Heinonen OP, Huttunen JK, Manninen V, et al. The Helsinki Heart Study: coronary heart disease incidence during an extended follow-up. J Intern Med. 1994 Jan;235(1):41-9. doi: 10.1111/j.1365-2796.1994.tb01030.x.
Younossi ZM, Loomba R, Anstee QM, et. al. Diagnostic modalities for nonalcoholic fatty liver disease, nonalcoholic steatohepatitis, and associated fibrosis. Hepatology. 2018 Jul;68(1):349-360. doi: 10.1002/hep.29721.
Seo SH, Shim YS. Association of Sleep Duration with Obesity and Cardiometabolic Risk Factors in Children and Adolescents: A Population-Based Study. Sci Rep. 2019 Jul 1;9(1):9463. doi: 10.1038/s41598-019-45951-0.
Copyright (c) 2019 CHILD`S HEALTH
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2019