title: A multidisciplinary clinical program is effective in stabilizing BMI and reducing transaminase levels in pediatric patients with NAFLD.
abstract: OBJECTIVE
  Weight loss is an effective treatment for children with nonalcoholic fatty liver disease (NAFLD), but it is extremely difficult to achieve outside of an intensive weight management program. We hypothesized that one can achieve success in improving NAFLD and weight-related outcomes in a structured and focused multidisciplinary clinical program feasible to implement in a gastroenterology clinic.
  
  
  METHODS
  We prospectively tracked the clinical status of our patients enrolled in a multidisciplinary program of dietary and exercise advice through an institutional review board-approved NAFLD registry. Each patient met with a gastroenterologist and dietitian every 3 months for 30 minutes to set individualized goals and monitor progress.
  
  
  RESULTS
  A total of 108 children have been enrolled in the registry, and of the 83 that were eligible for 1-year follow-up and included in the analysis, 39 patients returned, resulting in a 47% follow-up rate. These 39 patients showed statistically significant improvements in mean BMI z score (-0.1 U, P < 0.05), total (-11 mg/dL, P < 0.05) and low-density lipoprotein (9 mg/dL, P < 0.05) cholesterol, and serum alanine aminotransferase levels (-36 U/L) and aspartate aminotransferase levels (-22 U/L) levels.
  
  
  CONCLUSIONS
  A clinically feasible multidisciplinary program for obese pediatric patients with NAFLD stabilized BMI z score and significantly improved aminotransferase levels at 1-year follow-up.
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: DeVore
authors.forename: Rohit
authors.initials: R
authors.lastname: Kohli
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lake
authors.forename: Lynda
authors.initials: L
authors.lastname: Nicholas
authors.forename: Kim
authors.initials: K
authors.lastname: Dietrich
authors.forename: William F
authors.initials: WF
authors.lastname: Balistreri
authors.forename: Stavra A
authors.initials: SA
authors.lastname: Xanthakos
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004038:Diet, Reducing; D015444:Exercise; D005234:Fatty Liver / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000503:physiopathology*; D059012:Lost to Follow-Up; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology / Q000628:therapy; D010044:Outpatient Clinics, Hospital; D010353:Patient Education as Topic; D011446:Prospective Studies; D012042:Registries; D000637:Transaminases / Q000097:blood; D055815:Young Adult
chemical_list: D000637:Transaminases