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Metabolic and Nutritional Profile of Obese Adolescents With Nonalcoholic Fatty Liver Disease

de Piano, Aline; Prado, Wagner L; Caranti, Danielle A; Siqueira, Kãli O; Stella, Sérgio G; Lofrano, Mara; Tock, Lian; Cristofalo, Dejaldo MJ; Lederman, Henrique; Tufik, Sérgio; de Mello, Marco Túlio; Dâmaso, Ana R

Journal of Pediatric Gastroenterology & Nutrition: April 2007 - Volume 44 - Issue 4 - p 446–452
doi: 10.1097/MPG.0b013e31803815d9
Original Articles: Hepatology & Nutrition

Background: The incidence of nonalcoholic fatty liver disease (NAFLD) is increasing due to its prevalence in obesity, diabetes, and insulin-resistance syndrome. The best treatment protocol for NAFLD has not been determined. However, there is evidence that exercise and nutritional intervention can improve and prevent it. The aim of the present study was to evaluate the dietary and metabolic profiles of obese adolescents with NAFLD who participated in a multidisciplinary program.

Patients and Methods: We studied 43 adolescents ages 15 to 19 years (17.18 ± 1.66 years) with a body mass index (BMI) ≥30, consisting of 30 patients without NAFLD (BMI = 35.80 ± 3.44 kg/m2) and 13 with NAFLD (BMI = 33.47 ± 2.34 kg/m2). The NAFLD diagnosis was determined by ultrasonography. Blood samples were collected to analyze glycemia, hepatic aminotransferase levels, and lipid profiles. Insulin resistance was measured by homeostasis model assessment insulin-resistance index (HOMA-IR). The analyses of baseline and postintervention food intake were made by a 3-day inquiry.

Results: At baseline conditions, the patients with NAFLD showed significant differences in body mass, BMI, and visceral and subcutaneous fat. Glucose and visceral and subcutaneous fat presented a significant reduction after treatment in patients with NAFLD. Analyzing the food intake, at baseline we observed a positive correlation between the visceral obesity and lipid consumption only in patients with NAFLD. We also observed significant decrease in energy and cholesterol consumption in patients with NAFLD after the multidisciplinary therapy.

Conclusions: The intervention promoted a decrease in the prevalence of NAFLD, a significant decrease in visceral obesity, and improved HOMA-IR, glycemia, and serum lipid levels that are risk factors for NAFLD. In summary, the multidisciplinary program is essential in the treatment and prevention of NAFLD.

Federal University of São Paulo, Escola Paulista de Medicina UNIFESP-EPM, São Paulo, Brazil

Received 15 May, 2006

Accepted 17 January, 2007

Address correspondence and reprint requests to Nadja Ana R. Dâmaso, Rua Marselhesa no. 535-Vila Clementino, São Paulo/SP 04020-060, Brazil (e-mail: ana.damaso@unifesp.br).

Financial support was received from AFIP, CNPq, CAPES, FAPESP 2006/00684-3, CENESP, FADA, FAPESP (CEPID/Sleep #9814303-3 S.T), UNIFESP, and the CEPE Multidisciplinary Obesity Intervention Program.

© 2007 Lippincott Williams & Wilkins, Inc.