Effects of obesity reduction on transient elastography-based parameters in pediatric non-alcoholic fatty liver
Yoshiharu Isoura1, Yuki Cho1, Hiroki Fujimoto2
1Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan.
Insights
Obesity reduction in children with non-alcoholic fatty liver disease (NAFLD) significantly decreased hepatic fat deposition and liver stiffness. Short-term hospital admission for weight control proved more effective than self-directed management for pediatric NAFLD patients.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Obesity Medicine
Background:
- Non-alcoholic fatty liver disease (NAFLD) is a growing concern in obese children.
- Hepatic fat deposition and liver fibrosis are key indicators of NAFLD severity.
- Effective obesity management strategies are crucial for pediatric NAFLD patients.
Purpose of the Study:
- To investigate the impact of obesity reduction on NAFLD markers in obese children.
- To assess the effectiveness of different weight management approaches on liver health.
Main Methods:
- Studied 26 obese pediatric NAFLD patients undergoing weight management.
- Utilized transient elastography to measure controlled attenuation parameter (CAP) for fat and liver stiffness (LS) for fibrosis.
- Compared outcomes between regular hospital visits and short-term hospital admission for weight control.
Main Results:
- Weight and BMI percentile reductions positively correlated with CAP and LS reductions.
- Short-term hospital admission led to greater weight loss and significant reductions in CAP and LS compared to self-directed management.
- Baseline CAP, baseline LS, weight reduction, and alanine aminotransferase levels were significant factors in NAFLD improvement.
Conclusions:
- Weight reduction effectively reduces hepatic fat and liver stiffness in pediatric NAFLD.
- Short-term hospital admission offers a viable alternative for intensive weight management in non-responsive pediatric NAFLD cases.
- Targeted weight control interventions are essential for managing NAFLD in obese children.
Aim:
To clarify the effects of obesity reduction on non-alcoholic fatty liver disease (NAFLD) in obese children.
Methods:
Twenty-six obese pediatric NAFLD patients (median age, 13.0 years; range, 6.4-16.6 years), who underwent obesity management supported by regular hospital visits and/or hospital admission, were studied to explore how reductions in weight and body mass index (BMI) percentile affected two transient elastography-based parameters: controlled attenuation parameter (CAP) and liver stiffness (LS), which reflect the degree of hepatic fat deposition and liver fibrosis, respectively.
Results:
Univariate analysis revealed that CAP reduction was correlated positively with baseline CAP and reductions in weight and BMI percentile (r = 0.320-0.525), whereas LS reduction was correlated positively with baseline LS and reductions in weight, BMI percentile, aspartate transaminase, and alanine aminotransferase (r = 0.385-0.625). Multivariate analysis revealed that baseline CAP and reduction in weight were significantly associated with CAP reduction, whereas reduction in weight and alanine aminotransferase were significantly associated with LS reduction. Short-term weight control by hospital admission (24.9 ± 9.5 days) provided significantly higher reductions in weight and BMI percentile (both P < 0.001) and was associated with reductions of CAP and LS (P = 0.04 and 0.01) compared with regular hospital visit-supported self-directed weight management (0.9 ± 0.8 years).
Conclusions:
Weight reduction in obese pediatric NAFLD patients resulted in reduced hepatic fat deposition and liver stiffness. Weight control by short-term hospital admission is an alternative approach to regular hospital visit-supported self-directed weight management in NAFLD patients who fail to reduce obesity.
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