Factores alimenticios y sociodemográficos asociados con el hígado graso no alcohólico en pacientes pediátricos obesos

Abstract

Obesity is associated with nonalcoholic fatty liver disease (NAFLD) in children. Our aim was to analyze the association of dietary and sociodemographic factors with NAFLD in obese children and adolescents. Thirty-three obese patients from 6-16 years of age were included in the present analytic cross-sectional study. Obesity was diagnosed with a body mass index z-score > 2 SD. NAFLD was estimated by liver ultrasound, serum amino transferases, and elastography. The sociodemographic variables were evaluated using validated questionnaires. Diet was estimated through two 24-hour recall dietary surveys focused on the quantity of food energy, simple sugars, polyunsaturated fatty acids (PUFAs), and antioxidants. Hepatic steatosis was identified by abdominal ultrasound in 13 patients (39.4%) and the serum alanine aminotransferase level was above the upper reference value in 54.2%. A higher educational level in both parents, greater monthly food expenditure, and a higher socioeconomic level were associated with NAFLD. Overall, simple sugar and saturated fat consumption was above the recommended daily intake, whereas vitamin E and PUFA consumption was below those parameters. NAFLD was identified in one-third of the cases. There was an association between NAFLD and sociodemographic variables. Both groups had an increased intake of simple sugars and a reduced intake of PUFAs. The selective occurrence of NAFLD could be related to a genetic predisposition that has been demonstrated in a Mexican population.