Childhood obesity: a risk factor for non-alcoholic fatty liver disease in adolescence
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2019
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Abstract
Non-alcoholic fatty liver disease (NAFLD), defined as fat accumulation >5% in hepatocytes, may progress to fibrosis or cirrhosis later in life. NAFLD prevalence in adolescents has increased significantly in direct relation with obesity prevalence. Objective: To identify anthropometric variables during the first 10 years of life associated to the risk of developing NAFLD in adolescence. Methods: Longitudinal cohort study 'Growth and Obesity Chilean Cohort Study' (GOCS) consisting of 513 children born in 2002-2003, with yearly anthropometric data collected over a 10 year period. The presence of intra-hepatic fat in the livers of subjects 14-16 years of age was determined using abdominal ultrasound. In addition, elastography was performed on all participants with ultrasound evidence of NAFLD. Results: 9.7% of the participants presented findings compatible with NAFLD. After 2 years of age, obesity significantly and progressively increased the probability of NAFLD occurrence in adolescence. Obesity at 5 years of age was associated with the highest OR for NAFLD, reaching values of 8.91 (95% CI 3.03-16.11). Among participants with NAFLD, those with altered liver elasticity (≥7 Kpa) had greater weight, BMI z-score, waist and hip circumference and altered liver enzymes (p<0.05). Conclusion: The risk of developing NAFLD in adolescence increases progressively with early obesity starting at age 2 years.
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Tesis (Magíster en Nutrición)--Pontificia Universidad Católica de Chile, 2019