Doença hepática gordurosa não alcoólica (DHGNA) em pacientes pediátricos com excesso de peso - estudo retrospectivo unicêntrico

Abstract

OBJECTIVE: to assess the prevalence of non-alcoholic fatty liver disease (NAFLD) in a group of overweight/obese pediatric patients; to evaluate which clinical, anthropometric and laboratory parameters differ between patients with and without NAFLD and to associate the alterations with the presence of NAFLD. METHODS: retrospective observational study between 2012-2017, involving overweight/obese children and adolescents in 2 groups: WITH-NAFLD and WITHOUT-NAFLD. The presence of hepatic steatosis on ultrasound was considered for diagnosis of NAFLD. Studied variables: age, sex, systolic (SBP) and diastolic (DBP) blood pressure, birth weight (BW), weight, height, body mass index (BMI), BMI Z-score, waist circumference (WC), fasting blood glucose, insulin, IR-HOMA, triglycerides, total cholesterol and fractions, transaminases (ALT and AST) and thyroid stimulating hormone (TSH). Statistical analysis using Chi-square and Mann-Whitney tests for comparison between two groups; multivariate logistic regression analysis for association with NAFLD; p<0.05. RESULTS: 174 patients were evaluated, 35 WITH-NAFLD (20.1%). SBP>95th percentile (29 vs 14; p= 0.003), BMI (29.7 vs 27.5; p=0.010), BMI Z-score (3.2 vs 2.9; p=0.036), WC (93 vs 88.5; p=0.046), insulin (15.7 vs 12.8; p=0.028), IR-HOMA (3.2 vs 2.5; p=0.028) and ALT (39 vs 27, p<0.001) were significantly higher in WITH-DHGNA group. The others parameters did not differ. ALT was the only associated parameter with NAFLD (1.06; p=0.003) by multivariate logistic regression. CONCLUSION: one fifth of overweight/obese pediatric patients had NAFLD and had higher degrees of obesity, abdominal adiposity, insulin resistance and systolic pressure values. ALT was associated with NAFLD.