Relative antioxidant deficiency in obese children: A weighty contributor to morbidity?  

Oleh:

Lavine, Joel E.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The Journal of Pediatrics vol. 135 no. 02 (Feb. 1999), page 132-133.
Topik: NASH ; Nonalcoholic steatohepatitis

Ketersediaan

Perpustakaan FK Nomor Panggil: J45.K.1999.02 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Obesity in American children is common and increasingly prevalent, with 27% of 6- to 11-year-olds and 22% of 12- to 18-year-olds estimated to be overweight. Overweight children are more likely than normal-weight children to become overweight adults. Not surprisingly, obese children remaining obese as adults have greater health risks than those who become obese later in life. These risks include arteriosclerotic heart disease, angina pectoris, stroke, hypertension, non-insulin-dependent diabetes mellitus, obstructive sleep apnea, cholelithiasis, cholecystitis, gastroesophageal reflux disease, gout, nephrolithiasis, and sudden cardiac death. Detrimental metabolic alterations may include an atherogenic lipid profile, hyperglycemia, hyperinsulinemia, hyperuricemia, and increased fibrinogen levels. Obese children also demonstrate susceptibility to a form of fatty inflamed liver, termed nonalcoholic steatohepatitis . Serum aminotransferase levels (ie, alanine aminotransferase/aspartate aminotransferase) were elevated in 13% of obese Japanese teenagers without other identifiable causes of fatty liver. In a retrospective review of liver biopsy specimens at 3 major medical centers in Massachusetts, obesity was the major cause of NASH in the 8- to 14-year-old age group. The formidable association of childhood NASH with obesity was also found in a similar study of 30 patients from Toronto, Ontario, Canada. All of these children were greater than 2 standard deviations above the mean weight for age or greater than 1.2× ideal body weight. The mean serum alanine aminotransferase measurements were in the range of 100 to 200 IU, with slightly elevated serum alkaline phosphatase and normal total and direct bilirubin levels. Biopsy-proven histologic changes in the liver include microvesicular and macrovesicular steatosis, periportal lymphocytic inflammatory infiltrates, and frequent marked degrees of fibrotic change. Considering the prevalence of obesity and the frequency of elevated serum aminotransferases in this cohort, NASH is likely the major cause of chronic liver disease in North American 8- to 14-year-olds.

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