Factores asociados al hígado graso en una población pediátrica

Abstract

Introduction. Nonalcoholic fatty liver disease is the leading cause of chronic liver disease in children with an increasing prevalence and incidence, that evolves with fat deposition in the liver and generates a negative impact on the health and quality of life of patients. Objective. To determine the presence of variables associated with non-alcoholic fatty liver disease in the pediatric population studied. Methods. Observational, cross-sectional study, in which overweight or obese patients aged from 18 months to 16 years were included, treated in the Gastroenterology and Nutrition services of a tertiary pediatric hospital, from September 2009 to February 2019. Two groups were included: 1) "With Fatty Liver": patients with increased liver echogenicity and 2) "Without fatty liver": patients with normal ultrasound study. Both groups were compared analyzing anthropometric, biochemical, perinatal and personal history variables. Results. 371 overweight or obese patients were included, showing that a history of prematurity and low birth weight were factors associated with fatty liver. Preterm newborns have 14 times more chances of fatty liver than term newborns [OR 14.08 95% CI (2.31- 577.54)]; while patients with low birth weight (< 2500 g) have three times the chances of having fatty liver [OR 3.38 95% CI (1.01; 17.77)]. Exclusive breastfeeding up to the sixth month reduced the chances of fatty liver [OR 0.29 95% CI (0.15-0.53)]. Physical examination showed that acanthosis nigricans in the neck and armpits, and increased abdominal circumference were more prevalent in the Fatty Liver group (p < 0.05) as well as, the altered biochemical variables of aspartate aminotransferase and alanine aminotransferase, insulin (p < 0.05) and triglycerides (p = 0.0004). Conclusion: The search for variables associated with fatty liver is of vital importance in the early and timely diagnosis of this entity. The history of prematurity and low weight represent a risk factor, while exclusive breastfeeding up to the sixth month would prove to be a protective factor for the development of fatty liver. On physical examination, acanthosis nigricans and increased abdominal circumference were more common in the fatty liver group. Regarding the biochemical variables, the alteration of transaminases, insulin and triglycerides were significantly greater in the group with fatty liver.