A multidisciplinary clinical program is effective in stabilizing BMI and reducing transaminase levels in pediatric patients with NAFLD.

Abstract

BACKGROUND AND AIM:

Weight loss is an effective treatment for children with nonalcoholic fatty liver disease (NAFLD), but it is extremely difficult to achieve outside of an intensive weight management program. We hypothesized that one can achieve success in improving NAFLD and weight-related outcomes in a structured and focused multidisciplinary clinical program feasible to implement in a gastroenterology clinic.

METHODS:

We prospectively tracked the clinical status of our patients enrolled in a multidisciplinary program of dietary and exercise advice through an institutional review board-approved NAFLD registry. Each patient met with a gastroenterologist and dietitian every 3 months for 30 minutes to set individualized goals and monitor progress.

RESULTS:

A total of 108 children have been enrolled in the registry, and of the 83 that were eligible for 1-year follow-up and included in the analysis, 39 patients returned, resulting in a 47% follow-up rate. These 39 patients showed statistically significant improvements in mean BMI z score (-0.1 U, P < 0.05), total (-11 mg/dL, P < 0.05) and low-density lipoprotein (9 mg/dL, P < 0.05) cholesterol, and serum alanine aminotransferase levels (-36 U/L) and aspartate aminotransferase levels (-22 U/L) levels.

CONCLUSIONS:

A clinically feasible multidisciplinary program for obese pediatric patients with NAFLD stabilized BMI z score and significantly improved aminotransferase levels at 1-year follow-up.

• Authors: Stephanie DeVore, Rohit Kohli, Kathleen Lake, Lynda Nicholas, Kim Dietrich, William F Balistreri, Stavra A Xanthakos
• Journal: Journal of pediatric gastroenterology and nutrition (J Pediatr Gastroenterol Nutr) Vol. 57 Issue 1 Pg. 119-23 (Jul 2013) ISSN: 1536-4801 [Electronic] United States
• PMID: 23518484 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Transaminases

Topics

• Adolescent
• Adult
• Body Mass Index
• Child
• Child, Preschool
• Cohort Studies
• Combined Modality Therapy
• Diet, Reducing
• Exercise
• Fatty Liver (etiology, prevention & control)
• Female
• Follow-Up Studies
• Hospitals, Pediatric
• Humans
• Liver (enzymology, physiopathology)
• Lost to Follow-Up
• Male
• Non-alcoholic Fatty Liver Disease
• Obesity (blood, diet therapy, physiopathology, therapy)
• Outpatient Clinics, Hospital
• Patient Education as Topic
• Prospective Studies
• Registries
• Transaminases (blood)
• Young Adult