In:
BMC Pediatrics, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2019-12)
Abstract:
Childhood obesity is often associated with non-alcoholic fatty liver disease (NAFLD), the most common chronic liver disease in pediatrics. Methods This multi-center study analyzed liver echogenicity and liver enzymes in relation to obesity, age, gender and comorbidities. Data were collected using a standardized documentation software (APV) from 1.033 pediatric patients (age: 4–18 years, body mass index = BMI: 28–36 kg/m 2 , 50% boys) with overweight (BMI 〉 90th percentile), obesity (BMI 〉 97th percentile) or extreme obesity (BMI 〉 99.5th percentile) and obesity related comorbidities, especially NAFLD from 26 centers of Germany, Austria and Switzerland. Liver enzymes aspartate aminotransferase (AST), alanine-aminotransferase (ALT) and gamma glutamyltransferase (gammaGT) were evaluated using 2 cut-off values a) 〉 25 U/L and b) 〉 50 U/L. Multiple logistic regression models were used for statistical analysis. Results In total, 44% of the patients showed increased liver echogenicity. Liver enzymes 〉 25 U/L were present in 64% and 〉 50 U/L in 17%. Increased liver echogenicity was associated with elevated liver enzymes ( 〉 25 U/L: odds ratio (OR) = 1.4, 95% CI: 1.1–1.9, P 〈 0.02; 〉 50 U/L: OR = 3.5, 95% CI: 2.4–5.1, P 〈 0.0001). Extreme obesity, adolescence and male gender were associated with increased liver echogenicity (extreme obesity vs overweight OR = 3.5, 95% CI: 1.9–6.1, P 〈 0.0001; age 〉 14 years vs age 〈 9 years OR = 2.2, 95% CI: 1.4–3.5, P 〈 0.001; boys vs girls OR = 1.6, 95% CI: 1.2–2.0, P 〈 0.001) and elevated liver enzymes (extreme obesity vs overweight 〉 25 U/L: OR = 4.1, 95% CI: 2.4–6.9, P 〈 0.0001; 〉 50 U/L: OR = 18.5, 95% CI: 2.5–135, P 〈 0.0001; age 〉 14 years vs age 〈 9 years 〉 50 U/L: OR = 1.9, 95% CI: 1.0–3.7, P 〉 0.05; boys vs girls 〉 25 U/L: OR = 3.1, 95% CI: 2.4–4.1, P 〈 0.0001; 〉 50 U/L: OR = 2.1, 95% CI: 1.5–2.9, P 〈 0.0001). Impaired glucose metabolism showed a significant correlation with elevated liver enzymes 〉 50 U/L (OR = 4.4, 95% CI: 1.6–11.8, P 〈 0.005). Arterial hypertension seemed to occur in patients with elevated liver enzymes 〉 25 U/L (OR 1.6, 95% CI: 1.2–2.0, P 〈 0.005). Conclusions NAFLD is strongly related to extreme obesity in male adolescents. Moreover impaired glucose tolerance was observed in patients with elevated liver enzymes 〉 50 U/L, but arterial hypertension was only present in patients with moderately elevated liver enzymes 〉 25 U/L.
Type of Medium:
Online Resource
ISSN:
1471-2431
DOI:
10.1186/s12887-019-1711-4
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2019
detail.hit.zdb_id:
2041342-7
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