ESPE Abstracts

Background: Public health research shows that the prevalence of obesity is increasing rapidly not only among adults, but especially among adolescents and children. Obese children and adolescents are at risk of early chronic complications such as cardiovascular diseases, non-alcoholic fatty liver disease (NAFLD), type 2 diabetes mellitus, various types of tumors, orthopedic problems, serious psychological and neurological problems.

Aim: To investigate the prevalence and risk factors of NAFLD in obese and normal weight children.

Materials and methods: 198 study children were divided into 3 groups according to weight and age: group I – children ≥ 10 years old with obesity, group II – children < 10 years old with obesity, control group – normal weight children. In the study, ALT and blood lipid levels were determined, abdominal ultrasonography was performed and the paediatric NAFLD fibrosis index (PNFI) was calculated. All study data were analyzed using RStudio V.1.4.1103. Differences were considered statistically significant if the significance level was p < 0.05.

Results: ALT level above 24 U/l was observed in almost half, 44.9 % of children in group I, 26.3 % of children in group II, but not found in control group. 34.2 % of children in group I had signs of NAFLD on ultrasound, 12.5% of children in group II and no signs in control group. Analysis of PNFI showed that predicted liver fibrosis was found in 72.9% of children in group I, 76.7% of children in group II and not found in control group. The median PNFI score in groups I and II was 9.7 (IQR 8.9; 9.9) and 9.7 (IQR 9.2; 9.9), respectively, but only 0.4 (IQR 0.2; 0.7) in the control group (p < 0.001). There were statistically significantly gender differences: boys had the highest median PNFI value in group I – 9.9 (IQR 9.3; 10.0) compared to girls – 9.5 (IQR 8.4; 9.9) (P= 0.002).

Conclusions: Our study shows that elevated ALT level and ultrasound changes are more common in obese children compared to normal weight children. The PNFI index was significantly higher in group I boys compared to girls.