[Non-alcoholic fatty liver in children and adolescents with excess weight and obesity].
Hepatic steatosis, also known as non-alcoholic fatty liver (NAFL), is the most frequent liver disease in obese children. Due to an increase in infantile obesity, it is experiencing a significant increment in incidence. Our objetives are: Estimate the prevalence of NAFL in children with excess weight and obesity using the glutamate pyruvate transaminase (GPT) value as a biochemical test and an abdominal ultrasound, and correlate the presence of hepatic steatosis with various anthropometric and biochemical parameters.


METHODS
Cross-sectional prevalence study which includes children with excess weight and obesity between the ages of 5 and 15 years, between the years 2004-2012. The independent variables included were: age, sex, weight, size, body mass index (BMI), waist circumference (WC), waist size index (WSI), insulinemia, Homeostasis model assessment-insulin resistance (HOMA-R), total cholesterol, triglycerides (TG), high density lipoproteins (HDL), low density lipoproteins (LDL), glutamic-oxaloacetic transaminase (GOT), GPT and gamma-glutamyl transpeptidase (GGT).


RESULTS
One hundred and twenty-six patients, with an average age of 11.94 (3.12) years were recruited. A percentage of 19.66 of the patients presented elevated GPT pathology. Of the 126 abdominal ultrasounds performed, 38 patients presented hepatic steatosis (30.15%). The levels of insulinemia, HOMA-R and LDL were significantly higher in patients with altered GPT, compared to those with normal GPT values (P=.015, P=.008 and P=.002, respectively). The patients with an objective HGNA in ultrasound, also showed greater levels of insulinemia, WC, WSI, total cholesterol, TG, LDL, GLT, GPT and GGT than the patients with normal ultrasounds, thereby achieving statistical significance in insulinemia, HOMA-R, LDL and GPT values.


CONCLUSIONS
NAFL is a relatively frequent disorder in obese children and adolescents. In our study, 2 of 10 children -using GPT- and 3 of every 10 -using abdominal ultrasound- present the same. The biochemical marker which best defines it is an elevation in GPT. A modification in lifestyle which includes weight loss as a principal means of avoiding complications in adult life, is essential and necessary.
Servicio de Endocrinología y Nutrición, Hospital Universitario de Getafe, Getafe, Madrid, España. Electronic address: docguada@hotmail.com.
M Guadalupe
MG
Guijarro de Armas
Servicio de Endocrinología y Nutrición, Hospital Universitario de Getafe, Getafe, Madrid, España.
Susana
S
Monereo Megías
Servicio de Endocrinología y Nutrición, Hospital Universitario de Getafe, Getafe, Madrid, España.
Cristina
C
Navea Aguilera
Servicio de Endocrinología y Nutrición, Hospital Universitario de Getafe, Getafe, Madrid, España.
María
M
Merino Viveros
Servicio de Endocrinología y Nutrición, Hospital Universitario de Getafe, Getafe, Madrid, España.
M Belén
MB
Vega Piñero
D050153:Abdominal Fat / Q000000981:diagnostic imaging; D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D000886:Anthropometry; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D013030:Spain / Q000453:epidemiology; D014463:Ultrasonography; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D007328:Insulin; D008055:Lipids; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
Childhood Obesity; Esteatosis hepática; Glutamic pyruvic transaminase; Hepatic steatosis; Obesidad infantil; Transaminasa glutámico-pirúvica