Wang Chun-Lin, Liang Li, Fu Jun-Fen, Zou Chao-Chun, Hong Fang, Xue Jin-Zheng, Lu Jin-Rui, Wu Xiang-Min
Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, 57 Zhugan Xiang, Hangzhou 310003, Zhejiang Province, China.
World J Gastroenterol. 2008 Mar 14;14(10):1598-602. doi: 10.3748/wjg.14.1598.
To investigate the effect of lifestyle intervention on non-alcoholic fatty liver disease (NAFLD) in Chinese obese children.
Seventy-six obese children aged from 10 to 17 years with NAFLD were enrolled for a one-month intervention and divided randomly into three groups. Group1, consisting of 38 obese children, was an untreated control group without any intervention. Group 2, consisting of 19 obese children in summer camp, was strictly controlled only by life style intervention. Group 3, consisting of 19 obese children, received oral vitamin E therapy at a dose of 100 mg/d. The height, weight, fasting blood glucose (FBG), fasting serum insulin (FINS), plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglyceride (TG), total cholesterol (TCHO) and homeostasis model assent-insulin resistance (HOMA-IR) were measured at baseline and after one month. All patients were underwent to an ultrasonographic study of the liver performed by one operator who was blinded to the groups.
The monitor indices of BMI, ALT, AST, TG, TCHO and HOMA-IR were successfully improved except in group 1. BMI and ALT in group 2 were reduced more significantly than in group 3 (2.44 +/- 0.82 vs 1.45 +/- 0.80, P = 0.001; 88.58 +/- 39.99 vs 63.69 +/- 27.05, P = 0.040, respectively).
Both a short-term lifestyle intervention and vitamin E therapy have an effect on NAFLD in obese children. Compared with vitamin E, lifestyle intervention is more effective. Therefore, lifestyle intervention should represent the first step in the management of children with NAFLD.
探讨生活方式干预对中国肥胖儿童非酒精性脂肪性肝病(NAFLD)的影响。
纳入76例年龄在10至17岁的肥胖NAFLD儿童进行为期1个月的干预,并随机分为三组。第一组由38名肥胖儿童组成,为未接受任何干预的对照组。第二组由19名参加夏令营的肥胖儿童组成,仅通过生活方式干预进行严格控制。第三组由19名肥胖儿童组成,接受剂量为100mg/d的口服维生素E治疗。在基线和1个月后测量身高、体重、空腹血糖(FBG)、空腹血清胰岛素(FINS)、血浆丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、甘油三酯(TG)、总胆固醇(TCHO)和稳态模型评估胰岛素抵抗(HOMA-IR)。所有患者均由一名对分组不知情的操作人员进行肝脏超声检查。
除第一组外,BMI、ALT、AST、TG、TCHO和HOMA-IR的监测指标均得到成功改善。第二组的BMI和ALT下降比第三组更显著(分别为2.44±0.82 vs 1.45±0.80,P = 0.001;88.58±39.99 vs 63.69±27.05,P = 0.040)。
短期生活方式干预和维生素E治疗对肥胖儿童的NAFLD均有影响。与维生素E相比,生活方式干预更有效。因此,生活方式干预应作为NAFLD儿童管理的第一步。