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Observational Study
. 2021 Sep 3;21(1):385.
doi: 10.1186/s12887-021-02839-1.

Higher BMI predicts liver fibrosis among obese children and adolescents with NAFLD - an interventional pilot study

Hadar Moran-Lev #  1   2 , Shlomi Cohen #  3 , Muriel Webb  4 , Anat Yerushalmy-Feler  3 , Achiya Amir  3 , Dana L Gal  3 , Ronit Lubetzky  5
Affiliations
Observational Study

Higher BMI predicts liver fibrosis among obese children and adolescents with NAFLD - an interventional pilot study

Hadar Moran-Lev et al. BMC Pediatr. .

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) can range from simple steatosis to steatohepatitis with or without fibrosis. The predictors for liver fibrosis and the effect of nutritional intervention on hepatic fibrosis in pediatric population are not well established. We aimed to investigate the predictors for liver fibrosis and the effects of short-term nutritional intervention on steatosis and fibrosis among obese adolescents with NAFLD.

Methods: Cross-sectional study among obese adolescents. Sociodemographic and clinical data were collected. Liver fibrosis was estimated by Shearwave elastography. All participants were recommended to consume a low carbohydrate diet and were followed biweekly. Blood tests and elastography were performed upon admission and repeated after 3 months.

Results: Fifty-seven pediatric patients were recruited (35 males, mean age 13.5±2.9 years, mean body mass index [BMI] 38.8±9.7). Liver fibrosis was diagnosed in 34 (60%) subjects, which was moderate/severe (F≥2) in 24 (70%). A higher BMI Z score and moderate/severe steatosis correlated with moderate/severe fibrosis (P < 0.05). Seventeen patients completed 3 months of follow-up and displayed a decrease in BMI Z score (from BMI Z score 2.6±0.5 before intervention to 2.4±0.5 after intervention), with a significant decrease in liver fibrosis (P = 0.001).

Conclusion: Pediatric patients with high BMIs and severe liver steatosis are at risk for severe liver fibrosis. Nutritional intervention with minimal weight loss may improves hepatic fibrosis among the pediatric population.

Trial registration: TRN NCT04561804 (9/17/2020).

Keywords: Adolescent; Fibrosis; Liver; Obesity; Steatosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Determination of study sample
Fig. 2
Fig. 2
Differences in (a) percent of fibrosis distribution, (b) fibrosis stage, (c) percent of steatosis distribution, and (d) steatosis stage before and after dietary intervention
See this image and copyright information in PMC

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