Gallbladder Function and Hepatic Structural Changes in Children with Nonalcoholic Fatty Liver Disease
During the last decade, pediatric nonalcoholic liver disease has reached epidemic proportions, becoming one of the most frequent chronic liver diseases in the global child population. Purpose: to study the relationship of the functional state of the gallbladder with structural changes in the liver in children with nonalcoholic fatty liver disease. Materials and methods. We examined 34 children aged from 8 to 17 years old. Hepatic steatosis was determined using the FibroScan® 502 touch with controlled attenuation parameter (CAP). According to the results of transient elastometry and ultrasound of the abdomen with the gallbladder function study, patients were divided into 4 groups: the 1st group consisted of 7 patients with steatosis and hypofunction of gallbladder (20.5 %), group 2 included 6 patients with steatosis and gallbladder normofunction (17.65 %), group 3 consisted of 11 patients without hepatic steatosis with hypofunction of gallbladder (32.35 %), group 4 included 10 patients without hepatic steatosis with gallbladder normofunction (29.4 %). Results. The sonographic studies demonstrated children of the 1st group (steatosis with gallbladder hypokinesia) to have significantly larger sizes of liver lobes compared to group 4 (children without steatosis with gallbladder normofunction). Also, the stiffness of the liver parenchyma was highest in patients with hepatic steatosis and gallbladder hypokinesia. Discussion. The combination of hepatic steatosis and hypokinesia of the gallbladder in children is accompanied by a significant increase in liver size, increased stiffness of the liver parenchyma and increasing degree of steatosis. The data indicate the relationship of the gallbladder function and the liver structural changes.
Full Text:PDF (Українська)
Hutchinson J., Emerick J., Saxena H.The Future of Pediatric Obesity. Prim Care, 2016, no 43, no 1, рр. 1-17. doi: 10.1016/j.pop.2015.08.007.
Anderson E.L., Howe L.D., Jones H.E. The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis. PLoS One, 2015, no. 10, pp. 10. - e0140908. doi: 10.1371/journal.pone.0140908.
Kursawe R., Santoro N. Metabolic syndrome in pediatrics. Adv Clin Chem, 2014, no. 65, pp. 91-142.
Goldblatt M. I., Swartz—Basile D. A., AL—Azzawi H. H. Nonalcoholic Fatty gallbladder disease: the influence of diet in lean and obese mice. J. Gastrointest. Surg., 2006, no. 10, № 2, pp. 193—201.
Di Ciaula A., Wang D. Q., Portincasa P. Gallbladder and gastric motility in obese newborns, pre-adolescents and adults. J. Gastroenterol. Hepatol., 2012, no. 27, pp. 1298—1305. doi: 10.1111/j.1440—1746.2012.07149.x.
Mohamed H., Alia Asif. Nonalcoholic fatty liver disease and cholesterol gallstones: Which comes first? Scandinavian Journal of Gastroenterology, no 49., 2014, pp. 521-527.
de Lédinghen V., Le Bail B., Rebouissoux L. Liver stiffness measurement in children using FibroScan: feasibility study and comparison with Fibrotest, aspartate transaminase to platelets ratio index, and liver biopsy. J. Pediatr Gastroenterol Nutr., 2007, no. 45 (4), pp. 443-50.
Enjoji M., Yasutake K., Kohjima M. Nutrition and Nonalcoholic Fatty Liver Disease: The Significance of Cholesterol. International J. of Hepatology., 2012, no 6.
Lupşor-Platon Monica, Stefănescu Horia, Murean Daniel, Florea Mira. Noninvasive assessment of liver steatosis using ultrasound methods. Med Ultrason., 2014, no. 16 (3), pp. 236-245.
Goncharenko N., Tarasyuk B., Gridina T. [et al.] The motor-evacuation function of the gallbladder in children with chronic hepatitis and portal hypertension. Perinatologiya i pediatriya, 2011, №1 (45), рр. 76—79 (in Russian).
Obesity : Preventing and managing the Global Epidemic. Report of a WHO Consultation on Obesity [3—5 June 1997, Geneva] // HO/NUT/NCD/98.1. Режим доступу : http://www.who.int/nutrition/publications/obesity_executive_summary.pdf.
World Health Organization: Growth reference 5-19 years. BMI-for-age (5-19 years). — Режим доступу: http://www.who.int/growthref/who2007_bmi_for_age/en/
Katzmarzyk P. T. Waist circumference percentiles for Canadian youth 11-18 y of age. Eur.J.Clin.Nutr., 2004, no. 58, pp. 1011—1015.
McCarthy H. D., Jarrett K. V., Crawley H. F. The development of waist circumference percentiles in British children aged 5.0-16.9 years. Eur. J. Clin. Nutr., 2001, no. 55., pp. 902—907.
Order of the Ministry of Health care of Ukraine "On Approval of protocols treatment for children with endocrine diseases", № 255. Kiev, Publ., 2009. (In Ukrainian).https://www.moz.gov.ua/ua/portal/dn_20090203_55.html
- There are currently no refbacks.
Copyright (c) 2016 GASTROENTEROLOGY
This work is licensed under a Creative Commons Attribution 4.0 International License.
© Publishing House Zaslavsky, 1997-2018