Resumen

CAMACHO, Nolis et al. Steatosis Hepática en Niños y Adolecentes obesos: Asociación con adiposidad, lípidos, insulina y enzimas hepática. Rev. Venez. Endocrinol. Metab. [online]. 2010, vol.8, n.1, pp.19-29. ISSN 1690-3110.

Objectives: To study the frequency of hepatic steatosis (HS) in a group of obese children and adolescents and its association with anthropometric measurements, blood lipid levels, insulin resistance and aminotransferase. Methods: Twenty-two obese children (BMI> PC97) between 6 and 13 years old, (9.28 ± 1.9 years), 59% male and 41% female were included. Blood pressure and anthropometric measurements, including waist, were taken, and body mass index (BMI), fat and muscle area were calcaulated. Determinations of blood glucose and insulin in fasting and post-prandial, lipids and aminotransferases were made. With these data insulin resistance index, HOMA-IR was calculated. A liver ultrasound with transducers between 3 and 5 MHz was performed to study the presence of HS, according to the echogenicity, sound attenuation and visualization of vessels and diaphragm.Results: Forty-five percent (45%) of participants presented HS, 6 female and 4 male, a difference that did not become significant. In 14% the HS was mild, 27% moderate and 4% severe. Significant association was ob-served between the presence of HS and the elevated levels of aspartate aminotransferase (AST, P = 0.029) and alanine aminotransferase (ALT, P = 0.003). There was not a significant association with insulin resistance and lipid abnormalities. Those children with HS showed significantly higher values of BMI (p <0.005), waist (p <0.005), fat area (p <0.05), postprandial insulin (p <0.05), AST (p < 0.0001), ALT (p <0.0001) and alkaline phosphatase (p <0.0001) than those without HS. The logistic regression analysis, with the presence of HS as the dependent variable, showed that BMI was the most significant explanatory anthropometric variable (p=0.018, CI 95%: 1,12-3,52), and AST the most significant explanatory biochemistry variable (p = 0.032, CI 95%, 1,02-1,63).Conclusion: Hepatic steatosis is a common complication of obesity in children and adolescents, and it is associated with indicators of adiposity, mainly BMI, and with aminotransferase levels.

Palabras clave : Fatty liver; obesity; children and adolescents.