[State of the hepatobiliary system on the data of ultrasonic examination in children and adolescents with overweight and obesity].

Abstract

Currently, a stable increase in the incidence of overweight and obesity is noted, this fact leads to an elevation in comorbidity with them. The relevance of the study is due to the involvement of the hepatobiliary system in the development of metabolic dysfunction and the formation of non-alcoholic fatty liver disease in the future. The aim of the research was to study the effect of overweight and obesity in children and adolescents on the state of the hepatobiliary system on the basis of ultrasound examination. Material and methods. A single-center retrospective comparative study was conducted. The main group consisted of 112 children and adolescents with Z-score body mass index (BMI) above +1SD, the comparison group consisted of 264 persons with a BMI from -2 to +1SD aged 5-17 years. An analysis of the results of anthropometric, including the assessment of BMI, ultrasound and biochemical studies was carried out. Results. The Z-score of BMI corresponding to overweight was recorded in 54 (13.8%) examined persons, and obesity - in 58 (14.8%) patients. In children of the main group, an increase in the size of the liver was recorded 3.6 fold more often, diffuse changes in the liver were revealed 32.4 fold more often, an increase in the volume of the gallbladder - 2.1 fold, signs of excessive aerocolia - 3.3 fold more often (p<0.001). In children with overweight and obesity, the level of triglycerides (p=0.003), low-density lipoprotein cholesterol (p=0.035), glucose (p=0.012), C-reactive protein (p=0.011), malon dyalldehyde (p=0.012), the activity of alaninaminotransferase (p<0.001) and alkaline phosphatase (p=0.001) were statistically significant, with a significantly lower level of high-density lipoprotein cholesterol (p<0.001). Statistically significant logistic models of the probability of an increase in the linear dimensions of the liver, diffuse changes, an increase in the volume of the gallbladder, the presence of excessive aerocolia signs from the Z-score BMI value were obtained. The Nigelkirk determination coefficient was 0.34, 0.17, 0.11 and 0.10 c.u. respectively. Conclusion. The contribution of overweight and obesity to the increase in the linear dimensions of the liver and the volume of the gallbladder, the formation of diffuse changes and excessive aerocolia according to the ultrasound examination was 10-34%.