title: More Frequent Clinic Visits Are Associated with Improved Outcomes for Children with NAFLD.
abstract: Objective. Adult data suggest that frequent monitoring of patients with nonalcoholic fatty liver disease (NAFLD) may be associated with improved outcomes. The optimal frequency of outpatient visits for the management of pediatric NAFLD remains unknown.Study Design. In this retrospective study, two cohorts of patients with NAFLD, one followed on a yearly basis and one followed on 3-month intervals, were included. Both received similar advice regarding lifestyle changes. Primary outcome was change in BMIz-scores over a year. Secondary outcomes were the change in serum transaminases and markers of metabolic dysregulation.Results. Fifty-six patients were included (28 per group). The majority (71%) were male with a mean (±SD) age of 12.2 (±2.7) years. At baseline, there were no differences in BMIz-scores (2.8 versus 2.9;p= 0.72) and ALT levels (101 versus 100 U/L;p= 0.95) between the groups (yearly versus three-month, resp.). Twelve months later, those followed on a 3-month basis demonstrated a significant decrease in BMI (net BMIz-score change = -0.06;p= 0.37), accompanied by a significant improvement in serum ALT (-25 U/L;p< 0.01) and AST (-13 U/L;p= 0.03) levels. There were no differences in fasting lipid profiles.Conclusion. Frequent clinic visits are associated with improved outcomes in pediatric NAFLD.
authors.affiliation: Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Lam
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Bandsma
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: Simon
authors.initials: S
authors.lastname: Ling
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: Marialena
authors.identifier: 0000-0002-6186-2443
authors.initials: M
authors.lastname: Mouzaki
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000628:therapy*; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase