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Changes of liver fat content and transaminases in obese children after 12-mo nutritional intervention

World Journal of Hepatology 2013年第9期5卷 505-512页

作者： Elvira Verduci Carlo Pozzato Giuseppe Banderali Giovanni Radaelli chiara arrizza Antonio Rovere Enrica Riva Marcello Giovannini Department of Pediatrics San Paolo HospitalUniversity of Milan20142MilanItaly Unit of Medical Statistics San Paolo HospitalUniversity of Milan20142 MilanItaly Department of Radiology San Paolo Hospital20142 MilanItaly

AIM:To assess a relationship between longitudinal changes in liver fat content and biochemical parameters in obese children after 1-year nutritional ***:Forty-six obese children, 21 males and 25females, aged 6-14 years, underwent metabolic measurements, liver ultrasonography(US) and chemicalshift magnetic resonance imaging(MRI) examinations at baseline and after 1-year nutritional intervention. A child was defined obese if her/his body mass index(BMI)was above the age- and sex-adjusted BMI Cole's curve passing through the cut-off of 30 kg/m2 at 18 *** Z scores were calculated and adjusted for age and gender by using the Cole's LMS-method and Italian reference data. Biochemistry included serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST). Abdominal US and chemical-shift MRI were performed according to a randomized *** same radiologist performed US by a GE Logiq 9(General Electric Healthcare Medical Systems, Milwaukee, WI, United States) using a 3.5-MHz convex array transducer. Liver echogenicity was evaluated independently on videotape by 3 radiologists unaware of the child and MRI outcomes, and a consensus was established. Another experienced radiologist, unaware of the child and US data, performed the abdominal chemicalshift MRI with a 1-t system NT-Intera(Philips Medical Systems, Best, The Netherlands) and a phased-array coil. Liver fat fraction(FF) on MRI was judged elevated when greater than 9%. A FF>18% was considered expressing more severe cases of fatty liver according to Fishbein. A nutritional-behavioral intervention was recommended to promote a normocaloric balanced diet and active lifestyle based on the Italian guidelines for treatment of childhood ***:Compared to baseline, at the end of intervention children showed lower intakes of energy(mean± SD:2549±1238 Kcal vs 1770±622 Kcal, P<0.0001), total fat(90±47 g vs 52± 23g, P<0.0001),carbohydrates(356±174g vs 241±111 g, P=0.001),and protein(99±

关键词： Nonalcoholic fatty liver disease Childhood obesity Serum transaminases Magnetic resonance imaging Nutritional intervention

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