不同形式非酒精性脂肪肝患儿饮食行为特征

Y. Stepanov, N. Zavhorodnia, O. Zavhorodnia
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摘要

目的:研究不同形式的非酒精性脂肪性肝病(NAFLD) -单纯性脂肪变性(SS)和非酒精性脂肪性肝炎(NASH)患儿的饮食行为(EB)特征,并将所得数据与非肝脏脂肪变性患儿的饮食行为进行比较。120例患者年龄7 ~ 16岁,平均年龄(12.00±2.56)岁。肝脂肪变性的存在和程度是通过使用纤维扫描®502Touch的瞬时弹性成像来确定的,并评估CAP(受控衰减参数)。根据CAP、性别特异性丙氨酸转氨酶水平和体重指数,将患者分为4组:1组26例NASH患者,2组44例SS患者,3组35例无肝脂肪变性的肥胖患者,4组(对照组)15例体重正常无代谢紊乱患者。这些群体在年龄上是相同的。采用儿童版荷兰饮食行为问卷(DEBQ-C)对EB进行评估。大多数SS患者(75.0%)和NASH患者(87.5%)表现为情绪性EB。限制型EB在无肝脂肪变性的肥胖儿童中占主导地位(73.7%)。3组患儿限制性EB型总分显著高于4组(p< 0.05)。外部型EB发生在25%的SS患儿中,而在NASH患儿中未观察到。因此,与体重正常的儿童相比,患有NAFLD和肥胖的儿童的特点是各种不健康饮食行为的发生率增加,这需要适当的纠正和参与肥胖儿童保健的专家团队中的心理学家的参与。
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Features of eating behavior in children with different forms of non-alcoholic fatty liver disease
 Aim – to study the features of the eating behavior (EB) in children with different forms of nonalcoholic fatty liver disease (NAFLD) - simple steatosis (SS) and nonalcoholic steatohepatitis (NASH), to compare the obtained data with the eating behavior of children without liver steatosis. 120 patients aged 7 to 16 years were examined, the average age of the patients was (12.00 ± 2.56) years. The presence and degree of liver steatosis was determined by transient elastography using a FibroScan®502Touch with an assessment of CAP (controlled attenuation parameter). According to the CAP, gender-specific alanine aminotransferase levels and body mass index, patients were divided into 4 groups: 1 group consisted of 26 patients with NASH, 2 group – of 44 patients with SS, 3 group – of 35 patients with obesity without liver steatosis, 4 group (control) – of 15 patients with normal weight without metabolic disorders. The groups were homogeneous in age. Assessment of EB was carried out using the pediatric modification of the Dutch eating behavior questionnaire (DEBQ-C). It was found that most patients with SS (75,0%) and NASH (87,5%) demonstrated an emotional type of EB. The restrictive type of EB was predominant in obese children without hepatic steatosis (73,7%). The total score of the restrictive type of EB in children of the 3 group was significantly higher compared with the data of the 4 group (p<0,05). The external type of EB occurred in 25% of children with SS and was not observed in children with NASH. Thus, children with NAFLD and obesity are characterized by an increased incidence of various types of unhealthy eating behavior compared to children with normal weight, which requires appropriate correction and involvement of psychologists in a team of specialists involved in the health care of the obese children.
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