Nonalcoholic fatty liver disease, a common cause of chronic liver disease in adults, is incompletely characterized in children.
Dr Valerio Nobili and colleagues from Italy conducted a prospective study to better characterize the clinical presentation of nonalcoholic fatty liver disease in children.
The researchers determined the effect of lifestyle advice in the management of pediatric nonalcoholic fatty liver disease.
The team assessed 84 children who had elevated aminotransferases and diagnosed nonalcoholic fatty liver disease confirmed via liver biopsy from 2001 to 2003.
The children underwent a 2-hour oral glucose tolerance test and a 12-month program of lifestyle advice consisting of diet and physical exercise.
|A 12-month program with diet and physical exercise decreased levels of fasting glucose|
The team noted that 41% of patients were obese, and 51% were overweight.
The researchers found that 12% had abnormal glucose tolerance, 12% had elevated triglycerides, cholesterol, or both, and all had normal blood pressure.
Most children were insulin-resistant, including the 7 children with normal body mass index.
Increased liver fibrosis was present in 58% patients, and was independently associated with obesity and age.
A 12-month program with diet and physical exercise resulted in a significant decrease in body mass index.
The diet and exercise program decreased levels of fasting glucose, insulin, lipids, and liver enzymes, as well as liver echogenicity on ultrasonography.
Dr Nobili's team concludes, “Children with nonalcoholic fatty liver disease are almost always insulin-resistant regardless of body mass index.”
“Obesity and older age are independently associated with increased liver fibrosis.”
“A simple lifestyle advice program significantly improves insulin resistance, and the liver disease in pediatric nonalcoholic fatty liver disease.”