Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
Can J Gastroenterol Hepatol. 2016;2016:8205494. doi: 10.1155/2016/8205494. Epub 2016 Dec 12.
. Adult data suggest that frequent monitoring of patients with nonalcoholic fatty liver disease (NAFLD) may be associated with improved outcomes. The optimal frequency of outpatient visits for the management of pediatric NAFLD remains unknown. . In this retrospective study, two cohorts of patients with NAFLD, one followed on a yearly basis and one followed on 3-month intervals, were included. Both received similar advice regarding lifestyle changes. Primary outcome was change in BMI -scores over a year. Secondary outcomes were the change in serum transaminases and markers of metabolic dysregulation. . Fifty-six patients were included (28 per group). The majority (71%) were male with a mean (±SD) age of 12.2 (±2.7) years. At baseline, there were no differences in BMI -scores (2.8 versus 2.9; = 0.72) and ALT levels (101 versus 100 U/L; = 0.95) between the groups (yearly versus three-month, resp.). Twelve months later, those followed on a 3-month basis demonstrated a significant decrease in BMI (net BMI -score change = -0.06; = 0.37), accompanied by a significant improvement in serum ALT (-25 U/L; < 0.01) and AST (-13 U/L; = 0.03) levels. There were no differences in fasting lipid profiles. . Frequent clinic visits are associated with improved outcomes in pediatric NAFLD.
成人数据表明,频繁监测非酒精性脂肪性肝病(NAFLD)患者可能与改善结局相关。儿科 NAFLD 管理的门诊就诊最佳频率尚不清楚。
在这项回顾性研究中,纳入了两组 NAFLD 患者,一组每年随访,一组每 3 个月随访。两组均接受了关于生活方式改变的类似建议。主要结局是一年内 BMI 评分的变化。次要结局是血清转氨酶和代谢失调标志物的变化。
共有 56 名患者(每组 28 名)入选。大多数患者(71%)为男性,平均年龄(±标准差)为 12.2(±2.7)岁。基线时,两组的 BMI 评分(2.8 与 2.9; = 0.72)和 ALT 水平(101 与 100 U/L; = 0.95)无差异(每年与每 3 个月,分别)。12 个月后,每 3 个月随访的患者 BMI 显著下降(BMI 评分净变化 = -0.06; = 0.37),同时血清 ALT(-25 U/L; < 0.01)和 AST(-13 U/L; = 0.03)水平显著改善。空腹血脂谱无差异。
频繁的就诊与儿科 NAFLD 的改善结局相关。