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Disorders of gut-brain interaction (Rome IV) in Paediatric Obesity: Prevalence and correlation with inflammatory
Antonio Colucci1, Mara Creoli1, Giuseppina Rosaria Umano1
1Department of Woman, Child, General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Insights
Disorders of Gut-Brain Interactions (DGBIs) affect over a third of children with obesity, with functional constipation being most common. Altered bile acid levels and non-alcoholic fatty liver disease are linked to DGBIs in this population.
Area of Science:
- Pediatric Gastroenterology
- Metabolic Disorders
- Gut-Brain Axis Research
Background:
- Obesity is increasingly linked to Disorders of Gut-Brain Interactions (DGBIs).
- Altered inflammation markers are observed in obese individuals.
Purpose of the Study:
- To determine the prevalence of DGBIs in obese children.
- To investigate differences in inflammation markers between obese children with and without DGBIs.
Main Methods:
- Cross-sectional study of 200 obese children (BMI z-score > +2 SD).
- Evaluated DGBIs using Rome IV criteria, alongside anthropometry, lab tests, and bile acid (BA) levels.
- Assessed for non-alcoholic fatty liver disease (NAFLD).
Main Results:
- 36.5% of obese children had at least one DGBI, most commonly functional constipation (70.4%).
- DGBIs were significantly associated with altered serum BA levels, particularly in prepubertal children.
- 41.1% of children with DGBIs also had NAFLD.
Conclusions:
- DGBIs are highly prevalent in obese children, with functional constipation being the most common.
- Altered BA levels and NAFLD show a strong association with DGBIs, suggesting a shared metabolic pathway.
- These findings may inform future diagnostic and therapeutic strategies for DGBIs in pediatric obesity.
Background:
Several studies demonstrated a link between obesity and Disorders of Gut-Brain Interaction (DGBIs). In patients with obesity, it has been shown an alteration of inflammation markers.
Aims:
The study aims to assess the prevalence of DGBIs in pediatric population with obesity and to examine any potential differences in inflammation markers between children with and without DGBIs.
Methods:
We conducted a cross-sectional, observational study in children with obesity, analyzing age, sex, puberal stage, anthropometry, clinical history, laboratory tests, abdominal ultrasound, bile acid levels (BA) and evaluation of DGBIs assessed via Rome IV criteria RESULTS: A total of 200 children with BMI z-score > +2 SD were enrolled. Results showed that 36.5% of the children had at least one DGBI, with functional constipation (FC) (70.4%) being the most prevalent. A significant association was found between DGBIs and altered serum BA levels, with a higher prevalence in prepubertal children. Additionally, 41.1% of DGBI patients exhibited non-alcoholic fatty liver disease (NAFLD).
Conclusion:
Our results confirm that DGBIs are very common in the pediatric population with obesity and the most prevalent is FC. Moreover, the strong association between altered serum BA levels, NAFLD, and DGBI suggests a shared metabolic pathway that could be utilized for diagnosis and treatment.
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