Background: Fatty liver disease is diagnosed increasingly in obese children, which pathophysiology remains unexplained. Risk factors as insulin resistance, evolution of steatosis and hypertriglyceridemia, should be taken into consideration in its development.
Objective and hypotheses: To analyse the prevalence of hepatic steatosis identified by ultrasound, as well as features and anthropometric data in our population divided into 2 groups: with steatosis and without steatosis, to assess the risk factors. To determine the influence of those risk factors and assess the evolution of them, one year after diagnosis in patients divided into 2 groups(treated with diet and exercise vs treated with diet, exercise and metformin).
Method: In this cross-sectional study, 190 children aged 514 with BMI >2 S.D. were evaluated from 1st January 2012 to 31st May 2015. Anthropometric data, family history, biochemical parameters as fasting glucose, fasting insulin, lipid profile, index (HOMA-IR) and liver profile were evaluated. Liver ultrasound was performed to grade the presence of hepatic steatosis. All patients underwent to OGTT. The identification of hepatic steatosis was evaluated after one year. Metformin was given to patients with the criteria: Age >11 years, HOMA >3.5 and/or index glucose: Insulin >0.6 at 120′ in OGTT. Statistical analysis was performed by SPSS16.0 program.
Results: In the cohort of 190 patients, 70 presented within hepatic steatosis. They were divided into two groups of treatment(30 treated with diet and exercise vs 40 treated with diet, exercise and metformin). The mean age was (12±0.8 years vs 13.5±0.9 years). The prevalence of steatosis, after one year was (7.5% vs 2.5%) P<0.05. Fating insulin (16±3.5 mIU/ml vs 13±3.8 mIU/ml) P<0.05 and triglycerides (98±3.4 mg/dl vs 90±2.8 mg/dl) P<0.05. There was no significant difference in the BMI, abdominal circumference, total cholesterol and the hepatic transaminases.
Conclusion: In our study the prevalence of fatty liver is high, related with obesity and insulin resistance. Although weight loss contributes to reverse steatosis, patients treated with metformin get better results and evolution.
10 - 12 Sep 2016
European Society for Paediatric Endocrinology