Children and Adolescents with NAFLD See Decreased Fatty Liver Disease and Fibrosis with Lifestyle Therapy

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December 07, 2021

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Source / Disclosures

Disclosures: The study was funded by a grant from the Ghent University Hospital (FIKO19-TYPE2-006). Lefere declares that he has received a grant from the Foundation for Research – Flanders (FWO) (12R0321N).


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According to the results of the study, intensive lifestyle therapy in children and adolescents with non-alcoholic fatty liver disease resulted in significant weight loss and improvements in fatty liver and fibrosis.

“Implementing a structured lifestyle program is a promising therapeutic approach for pediatric NAFLD” Sander THEefere, MD, PhD, of the Hepatology Research Unit of the Department of Internal Medicine and Pediatrics of the Liver Research Center at Ghent University in Belgium, and his colleagues wrote in Clinical gastroenterology and hepatology. “Alternative outpatient weight loss programs for NAFLD should be developed and evaluated. “

Lefere and colleagues evaluated 204 children (median age, 14 years; 51% girls; median BMI, 36 kg / m2 corresponding to BMI z score of +2.76) and adolescents admitted to a tertiary center for severe obesity. Investigators noted that intensive lifestyle therapy included calorie restriction, physical activity, healthy lifestyle education, and psychosocial support. Liver ultrasound and transient elastography with controlled attenuation parameter (CAP) were performed at baseline at 6 and 12 months to assess liver stenosis and fibrosis.

In 71.1% of patients, investigators observed NAFLD present on ultrasound, which was severe in 20.1%. There were 68.6% who had CAP values ​​of 248 dB / m or more. Lefere and his colleagues noted that 32.8% of patients had at least one F2 fibrosis, with 10.3% who had a transient elastography of 9 kPa or greater.

According to the researchers, the median weight loss was 16% in 167 patients evaluated at 6 months. In 75% of patients, fibrosis improved (P <.001 predictors of fibrosis resolution included baseline severity hepatic and steatosis.>

Investigators noted that there were 79 patients who reached the 1-year time point. Improvements in patients have been sustained. In all patients with initial fibrosis, the fibrosis had regressed by at least one stage. Over the one-year period, the assessment of the fasting serum alanine aminotransferase pattern and insulin resistance homeostasis decreased (P


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