• Nonalcoholic fatty liver disease — a component of the metabolic syndrome in the infancy and adolescence 
To content

Nonalcoholic fatty liver disease — a component of the metabolic syndrome in the infancy and adolescence 

SOVREMENNAYA PEDIATRIYA.2014.2(58):107-110; doi 10.15574/SP.2014.58.107 
 

Nonalcoholic fatty liver disease — a component of the metabolic syndrome in the infancy and adolescence 
 

Parkhomenko L. K., Strashok L. A., Buznitskaya E. V., Isakova M. Yu., Zavelya E. M., Eshenko A. V.

Kharkiv Medical Academy of Postgraduate Education, Ukraine 

Objective: To identify early markers of metabolic syndrome in the infancy and adolescence.

Patients and methods. A total of 304 patients with obesity in the age 7–18 years were under observation. Patients underwent anthropometry with the definition of the body mass index, blood lipid study, ultrasound study and also the determination of HOMA index. Biochemical markers of the liver fibrogenesis intensity — fibronectin and type IV collagen in the blood serum were determined by the method of enzyme immunoassay ELISA. 
 

Results. In the 1/3 of children and adolescents with obesity was diagnosed chronic pathology of the hepatobiliary system. In the half of the patients were identified functional disorders of the biliary tract, the symptoms of chronic cholecystitis in — 11% of patients. During the ultrasound study was found an enlarged liver and decreased echogenicity of its parenchyma in 1/4 of patients with obesity, evidently more frequently in adolescents with insulin resistance. In all patients were found signs of moderate atherogenic dyslipidemia, more pronounced at presence of insulin resistance. Examination of the extracellular matrix of liver and fibrogenesis had found a significant increase in the levels of collagen type IV and fibronectin in adolescents with obesity, more pronounced in patients with insulin resistance. 
 

Conclusions. Formation of non-alcoholic fatty liver disease during the obesity in the infancy and adolescence is confirmed by ultrasound study of liver and increased fibrogenesis markers in the blood serum. In all patients with obesity were defined atherogenic changes in lipid profile, more pronounced in the setting of insulin resistance. Obesity and diagnosis of non-alcoholic fatty liver disease may be as an early signs of metabolic syndrome in the infancy and adolescence. 
 

Key words: non-alcoholic fatty liver disease, metabolic syndrome, obesity, children, adolescents. 
 

REFERENCES

1. Бабак ОЯ, Кравченко НА. 2012. Сывороточные биомаркеры и фибротесты в диагностике фиброза печени: недостатки и перспективы. Сучасна гастроентерол. 3(65): 71—80.

2. Болотова НВ, Лазебникова СВ, Аверьянов АП. 2007. Особенности формирования метаболического синдрома у детей и подростков. Педиатрия. 3: 35—39.

3. Пархоменко ЛК, Страшок ЛА, Ещенко АВ, Бузницкая ЕВ. 2011. Вопросы диагностики неалкогольной жировой болезни печени в подростковом возрасте. Здоровье ребенка. 7(34): 107—112.

4. Захарова ИН, Яблочкова СВ. 2010. Метаболический синдром: взгляд педиатра. Эксперимент и клин гастроэнтерол. 7: 84—91.

5. Звенигородская ЛА. 2007. Клинико-функциональные и морфологические изменения печени у больных с метаболическим синдромом. Consilium medicum. 2: 21—24.

6. Алимова ИЛ и др. 2008. Метаболический синдром у детей и подростков. Под ред ЛВ Козловой. М, ГЭОТАР-Медиа: 96с.

7. Павлов ЧС, Глушенков ДВ, Буличенко МА и др. 2010. Неалкогольная жировая болезнь печени в клинике внутренних болезней. РМЖ. 18;28(392): 1742— 1748.

8. Пирогова ИЮ, Пышкин СА. 2011. Диагностика фиброза печени: инвазивные и неинвазивные методы. Сибир мед журн. 3: 10—15.

9. Чазова ИЕ, Мычка ВБ, Кисляк ОА и др. 2009. Проект Рекомендаций экспертов ВНОК по диагностике и лечению метаболического синдрома (второй пересмотр): 40.

10. Семендяева МЕ. 2012. Неалкогольная жировая болезнь печени как медицинская и социальная проблема. Клин практика. 2: 71—80.

11. Урсова НИ. 2010. Жировая дистрофия печени при метаболическом синдроме в практике врача-педиатра. Лечащий врач. 1: 37—40.

12. Чазова ИЕ, Мычка ВБ. 2008. Метаболический синдром. М, Медиа Медика: 324.

13. Чернявский ВВ. 2011. Жировая болезнь печени как интегральная проблема внутренней медицины. Нов медицины и фармации. 4(354): 64—67.

14. Dubose KD. 2006. Prevalence of the metabolic syndrome in elementary school children. Acta Pediatrica. 95(8): 1005—1011. http://dx.doi.org/10.1080/08035250600570553 
PMid:16882578

15. Dongiovanni P, Valenti L, Rametta R et al. 2010. Genetic variants regulating insulin receptor signaling are associated with the severity of liver damage in patients with nonalcoholic fatty liver disease. Gut. 59: 267—273.

16. Jolliffe CJ, Janssen J. 2007. Development of Age-Specific Adolescent Metabolic Syndrome Criteria That is Linked to the Adult Treatment Panel III and International Diabetes Federation Criteria. J Am Coll Cardiol. 49: 891—898.

17. Kotronen A, Yki-Jarvinen H. 2008. Fatty liver: a novel component of the metabolic syndrome. Arterioscler Thromb Vas Biol. 28(l): 27—38.

18. Kistler KD, Molleston J, Unalp A, Abrams SH. 2010. Symptoms and Quality of Life in Obese Children and Adolescents with Non-alcoholic Fatty Liver Disease Posted: 02/01/2010. Alimentary Pharmacology s Therapeutics. 31(3): 396—406. http://dx.doi.org/10.1111/j.1365-2036.2009.04181.x 
PMid:19863497 PMCid:PMC2807909

19. Zimmet P, Alberti KG, Kaufman F et al. 2007. The metabolic syndrome in children and adolescents — an IDF consensus report. Pediatric Diabetes. 8: 299—306.

20. Feldstein AE, Charatcharoenwitthaya Р, Treeprasertsuk S, Benson JT. 2009. The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years. Gut. 58: 1538—1544.