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Экспериментальная и клиническая гастроэнтерология

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Неалкогольная жировая болезнь печени и метаболический синдром в детском возрасте

https://doi.org/10.31146/1682-8658-ecg-183-11-51-61

Аннотация

Имеются многочисленные факты, что в основе развития неалкогольной жировой болезни печени (НАЖБП) лежит инсулин резистентность, гиперинсулинемия и ожирение. Болезнь теперь рассматривают как печеночный компонент метаболического синдрома (МС).

64 ребёнка с НАЖБП были оценены на стигмы метаболического синдрома. Также был сделан анализ о состоянии проблемы по данным литературы относительно общих звеньев патогенеза этих состояний, методов диагностики и лечения НАЖБП.

Все составляющие МС с разной частотой наблюдаются у больных с НАЖБ. Это заболевание вместе с сахарным диабетом 2 типа становится очень распространенными заболеваниями и в детском возрасте. Заболеваемость НАЖБП у детей постоянно растет, она стала встречаться у младенцев, возможен исход в цирроз печени в пределах детского возраста, хотя прогноз при НАЖБП остается точно неопределенным. Снижение веса при назначении диеты с низким гликемическим индексом, регулярные физических упражнения и другие изменения образа жизни являются основой лечения НАЖБП, но пока не слишком эффективным по разным причинам. В этих условиях необходимо повысить роль первичной профилактики МС и НАЖБП.

Об авторах

Н. Н. Власов
ФБГОУ ВО Санкт-Петербургский государственный педиатрический медицинский университет МЗ РФ
Россия

Власов Николай Николаевич, к. м. н., доцент кафедры детских болезней.

194100, Санкт-Петербург, ул. Литовская 2



Е. А. Корниенко
ФБГОУ ВО Санкт-Петербургский государственный педиатрический медицинский университет МЗ РФ
Россия

Корниенко Елена Александровна, д. м. н., профессор кафедры детских болезней.

194100, Санкт-Петербург, ул. Литовская 2



Список литературы

1. Das K., Mukherjee P. S., Ghosh A., et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease. Hepatology 2010, vol. 51, pp. 1595–1602.

2. Бутурова Л. И. «Неалкогольная жировая болезнь печени как проявление метаболического синдрома: эпидемиология, патогенез, особенности клинического проявления, принципы диагностики, современные возможности лечения.» // Пособие для врачей. Москва, 2012, 52 с.

3. Nobili V., Alkhouri N., Alisi A., et al. Nonalcoholic fatty liver disease: a challenge for pediatricians. J. Am. Med. Assoc. Pediatr. 2015, vol. 169, pp. 170–176.

4. Popkin B. M., Adair L. S., Ng S. W. Global nutrition transition and pandemic of obesity in developing countries. Nutr. Rev. 2012, vol. 70, pp. 3–21.

5. Wong R. J., Aguilar M., Cheung R., et al. Nonalcoholic steatohepatitis is the second leading etiology of liver disease among adults awaiting liver transplantation in the United States. Gastroenterology 2015, vol. 148, pp. 547–555.

6. Stefan N et al. Metabolically healthy obesity: epidemiology, mechanisms, and clinical implications. The Lancet Diabetes & Endocrinology. 2013. vol. 1, no. 2, pp. 152–162.

7. Semple R. K., Savage D. B., Cochran E. K. et al. Genetic syndromes of severe insulin resistance. Endocr. Rev. 2011, vol. 32, pp. 498–514.

8. Roberts E. A. Nonalcoholic Steatosis. In book: edited by Deirdre Kelly: Diseases of the liver and biliary system in children – 3rd ed. A John Wiley & Sons, Ltd., Publication, © 2008. Blackwell Publishing, pp. 253–269.

9. Balagopal P., George D., Yarandi H., et al. Reversal of obesity-related hypoadiponectinemia by lifestyle intervention: a controlled, randomized study in obese adolescents. J. Clin. Endocrinol. Metab. 2005. vol. 90, pp. 6192–6197.

10. Barlow S. E. Expert Committee recommendations regarding the prevention, assessments, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007, vol. 120(Suppl. 1), pp. S164-S192.

11. Nobili V., Svegliati-Baroni G., Alisi A., et al. A 360-degree overview of paediatric NAFLD: recent insights. J. Hepatol. 2013, vol. 58, pp. 1218–1229.

12. Torley D., Munro C. S. Genes, growth factors and acanthosis nigricans. Br. J. Dermatol. 2002. vol. 147, pp. 1096–1101.

13. de Almeida I. T., Cortez-Pinto H., Figaldo G., et al. Plasma total and free fatty acids composition in human non-alcoholic steatohepatitis. Clin. Nutr. 2002. vol. 21, pp. 219–223.

14. Day C. P.: Pathogenesis of steatohepatitis. Best. Pract. Res. Clin. Gastroenterol. 2002. vol. 16, pp. 663–678.

15. Feldstein A. E., Werneburg N. W., Canbay A, et al. Free fatty acids promote hepatic lipotoxicity by stimulating TNF-alpha expression via a lysosomal pathway. Hepatology. 2004. vol. 40, pp. 185–194.

16. Boden G., She P., Mozzoli M., et al. Free fatty acids produce insulin resistance and activate the proinflammatory nuclear factor-kB pathway in rat liver. Diabetes. 2005. vol. 54, pp. 3458–3465.

17. Fishbein M. H., Mogren C., Gleason T, et al. Relationship of hepatic steatosis to adipose tissue distribution in pediatric nonalcoholic fatty liver disease. J. Pediatr. Gastroenterol. Nutr. 2006. vol. 42, pp. 83–88.

18. Franzese A., Vajro P., Argenziano A., et al. Liver involvement in obese children. Ultrasonography and liver enzyme levels at diagnosis and during follow-up in an Italian population. Dig. Dis. Sci. 1997. vol. 42, pp. 1428–1432.

19. Goran M. I., Gower B. A.: Longitudinal study on pubertal insulin resistance. Diabetes 2001. vol. 50, pp. 2444–2450.

20. Ueki K., Kadowaki T., Kahn C. R. Role of suppressors of cytokine signaling SOCS-1 and SOCS-3 in hepatic steatosis and the metabolic syndrome. Hepatol. Res. 2005. vol. 33, pp. 185–192.

21. Foufelle F., Ferre P. New perspectives in the regulation of hepatic glycolytic and lipogenic genes by insulin and glucose: a role for the transcription factor sterol regulatory element binding protein-1c. Biochem. J. 2002. vol. 366, pp. 377–391.

22. Horton J. D., Goldstein J. L., Brown M. S. SREBPs: activators of the complete program of cholesterol and fatty acid synthesis in the liver. J. Clin. Invest. 2002. vol. 109, pp. 1125–1131.

23. Pacifico L., Di Renzo L., Anania C., et al. Increased T-helper interferon-gamma-secreting cells in obese children. Eur. J. Endocrinol. 2006. vol. 154, pp. 691–697.

24. Nobili V., Marcellini M., Devito R., et al. NAFLD in children: a prospective clinical-pathological study and effect of lifestyle advice. Hepatology 2006. vol. 44, pp. 458–465.

25. Mager D. R., Ling S., Roberts E. A. Anthropometric and metabolic characteristics in children with clinically diagnosed nonalcoholic fatty liver disease. Paediatr Child Health. 2007. vol. 13, pp. 111–117.

26. Patton H. M., Sirlin С., Behling С., et al. Pediatric Nonalcoholic Fatty Liver Disease: A Critical Appraisal of Current Data and implications for Future Research. J. Pediatr. Gastroenterol. Nutr. 2006, vol. 43, pp. 413–427.

27. Cook J. S., Hoff man R. P., Stene M. A., et al. Effects of maturational stage on insulin sensitivity during puberty. J. Clin. Endocrinol. Metab. 1993. vol. 77, pp. 725–730.

28. Roemmich J. N., Clark P. A., Lusk M., et al. Pubertal alterations in growth and body composition. VI. Pubertal insulin resistance: relation to adiposity, body fat distribution and hormone release. Int. J. Obes. Relat. Metab. Disord. 2002. vol. 26, pp. 701–709.

29. Gungor N., Saad R., Janosky J., et al. Validation of surrogate estimates of insulin sensitivity and insulin secretion in children and adolescents. J. Pediatr. 2004. vol. 144, pp. 47–55.

30. Keskin M., Kurtoglu S., Kendirci M., et al. Homeostasis model assessment is more reliable than the fasting glucose/insulin ratio and quantitative insulin sensitivity check index for assessing insulin resistance among obese children and adolescents. Pediatrics 2005. vol. 115, pp. e500–e503.

31. Schwimmer J. B., Deutsch R., Rauch J. B., et al. Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. J. Pediatr. 2003. vol. 143, pp. 500–505.

32. Kawasaki T., Hashimoto N., Kikuchi T., et al. The relationship between fatty liver and hyperinsulinemia in obese Japanese children. J. Pediatr. Gastroenterol. Nutr. 1997. vol. 24, pp. 317–321.

33. Schwimmer J. B., Behling C., Newbury R., et al. Histopathology of pediatric nonalcoholic fatty liver disease. Hepatology 2005. vol. 42, pp. 641–649.

34. Chan D. F., Li A. M., Chu W. C., et al. Hepatic steatosis in obese Chinese children. Int. J. Obes. Relat. Metab. Disord. 2004. vol. 28, pp. 1257–1263.

35. Nadeau K. J., Klingensmith G., Zeitler P. Type 2 diabetes in children is frequently associated with elevated alanine aminotransferase. J. Pediatr. Gastroenterol. Nutr. 2005. vol. 41, pp. 94–98.

36. Asayama K., Hayashibe H., Dobashi K., et al. Decrease in serum adiponectin level due to obesity and visceral fat accumulation in children. Obes. Res. 2003. vol. 11, pp. 1072–1079.

37. Diamond F. B. Jr., Cuthbertson D., Hanna S., et al. Correlates of adiponectin and the leptin/adiponectin ratio in obese and non-obese children. J. Pediatr. Endocrinol. Metab. 2004. vol. 17, pp. 1069–1075.

38. Weiss R., Dziura J., Burgert T. S., et al. Obesity and the metabolic syndrome in children and adolescents. N. Engl. J. Med. 2004. vol. 350, pp. 2362–2374.

39. Bacha F., Saad R., Gungor N., Arslanian S. A.: Adiponectin in youth: relationship to visceral adiposity, insulin sensitivity, and beta-cell function. Diabetes Care. 2004. vol. 27, pp. 547–552.

40. Uygun A., Kadayifci A., Yesilova Z., et al. Serum leptin levels in patients with nonalcoholic steatohepatitis. Am. J. Gastroenterol. 2000. vol. 95, pp. 3584–3589.

41. Wang J., Obici S., Morgan K., et al. Overfeeding rapidly induces leptin and insulin resistance. Diabetes 2001. vol. 50, pp. 2786–2791.

42. Kennedy A., Gettys T. W., Watson P, et al. The metabolic significance of leptin in humans: gender-based differences in relationship to adiposity, insulin sensitivity, and energy expenditure. J. Clin. Endocrinol. Metab. 1997. vol. 82, pp. 1293–1300.

43. McMullen S.: Childhood obesity: the impact on long-term risk of metabolic and CVD is not necessarily inevitable. Proc. Nutr. Soc. 2014. vol. 73, pp. 389–396.

44. Lakshman R, Elks CE, Ong KK. Childhood obesity. Circulation 2012. vol. 126, pp. 1770–1779.

45. Kiess W., Reich. A, Muller G., et al. Clinical aspects of obesity in childhood and adolescence-diagnosis, treatment and prevention. Int. J. Obes. Relat. Metab. Disord. 2001. vol. 25(Suppl 1), pp. S75–S79.

46. Cole T. J., Bellizzi M. C., Flegal K. M., Dietz W. H. Establishing a standard defi nition for child overweight and obesity worldwide: international survey. BMJ 2000. vol. 320, pp. 1240–1243.

47. McCarthy H.D., Ashwell M.: A study of central fatness using waist-to-height ratios in UK children and adolescents over two decades supports the simple message – “keep your waist circumference to less than half your height.” Int. J. Obes. (Lond) 2006. vol. 30(no 6), pp. 988–992.

48. Kiess W., Penke M., Sergeyev E., et al. Childhood obesity at the crossroads. J. Pediatr. Endocrinol. Metab. 2015. vol. 28, pp. 481–484.

49. Penke M., Kiess W., de Giorgis T.: Non-alcoholic fatty liver disease in children and adolescents. J. Pediatr. Endocrinol. Metab. 2016. vol. 29(no 12), pp. 1329–1330.

50. Strauss R. S., Barlow S. E., Dietz W. H. Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents. J. Pediatr. 2000. vol. 136, pp. 727–733; 23.

51. Tominaga K., Kurata J. H., Chen Y. K. et al. Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey. Dig.Dis. Sci. 1995. vol. 40, pp. 2002–2009.

52. Schwimmer J. B., Deutsch R., Kahen T., et al. Prevalence of fatty liver in children and adolescents. Pediatrics 2006; 118: 1388–1393.

53. Noguchi H., Tazawa Y., Nishinomiya F., et al. The relationship between serum transaminase activities and fatty liver in children with simple obesity. Acta Paediatr. Jpn. 1995; 37: 621–625.

54. Guzzaloni G., Grugni G., Minocci A., et al. Liver steatosis in juvenile obesity: correlations with lipid profi le, hepatic biochemical parameters and glycemic and insulinemic responses to an oral glucose tolerance test. Int. J. Obes. Relat. Metab. Disord. 2000; 24: 772–776.

55. Perseghin G., Bonfanti R., Magni S., et al. Insulin resistance and whole body energy homeostasis in obese adolescents with fatty liver disease. World J. Gastroenterol. 2009 January 28; 15(4): 473–477.

56. Fishbein M. H., Mogren C., Gleason T, et al. Relationship of hepatic steatosis to adipose tissue distribution in pediatric nonalcoholic fatty liver disease. J. Pediatr. Gastroenterol. Nutr. 2006; 42: 83–88.

57. Goran M. I., Gower B. A. Relation between visceral fat and disease risk in children and adolescents. Am. J. Clin. Nutr. 1999; 70: 149S-156S.

58. Manton N. D., Lipsett J., Moore D. J., et al. Non-alcoholic steatohepatitis in children and adolescents. Med. J. Aust. 2000; 173: 476–479.

59. Rashid M., Roberts E. A. Nonalcoholic steatohepatitis in children. J. Pediatr. Gastroenterol. Nutr. 2000; 30: 48–53.

60. Della Corte C. D., Mosca A., Lucidi V., et al. Non-alcoholic steatohepatitis in childhood. In book edited by Deirdre Kelly: Diseases of the liver and biliary system in children 4rd ed. A John Wiley & Sons, Ltd., Publication, © 2017 Blackwell Publishing, pp. 227–240.

61. Arslan N., Buyukgebiz B., Ozturk Y., et al. Fatty liver in obese children: prevalence and correlation with anthropometric measurements and hyperlipidemia. Turk. J. Pediatr. 2005; 47: 23–27.

62. Nobili V., Alkhouri N., Bartuli A., et al. Severity of liver injury and atherogenic lipid profi le in children with nonalcoholic fatty liver disease. Pediatr. Res. 2010; 67: 665–670.

63. Papandreou D., Rousso I., Makedou A., et al. Is there any association between high-density lipoprotein, insulin resistance and non-alcoholic fatty liver disease in obese children? Int. J. Food Sci. Nutr. 2009 Jun; 60(4): 312–318.

64. Sathya P., Martin S., Alvarez F. Nonalcoholic fatty liver disease (NAFLD) in children. Curr. Opin. Pediatr. 2002; 14: 593–600.

65. Dunger D. B. Obesity and the insulin resistance syndrome. Arch. Dis. Child. 2005; 90: 1.

66. Scaglioni S., Verduci E., Salvioni M., et al., ppAR-gamma2 Pro12Ala variant, insulin resistance and plasma longchain polyunsaturated fatty acids in childhood obesity. Pediatr. Res. 2006; 60: 485–489.

67. Berberoglu M., Evliyaoglu O., Adiyaman P., et al. Plasminogen activator inhibitor-1 (PAI-1) gene polymorphism (–675 4G/5G) associated with obesity and vascular risk in children. J. Pediatr. Endocrinol. Metab. 2006; 19: 741–748.

68. Heude B., Petry C. J., Pembrey M., et al. The insulin gene variable number of tandem repeat: associations and interactions with childhood body fat mass and insulin secretion in normal children. J. Clin. Endocrinol. Metab. 2006; 91: 2770–2775.

69. Abdelmalek M. F., Suzuki A., Guy C., et al. Increased fructose consumption is associated with fibrosis severity in patients with nonalcoholic fatty liver disease. Hepatology 2010; 51: 1961–1971.

70. Welsh J. A., Sharma A., Abramson J. L., et al. Caloric sweetener consumption and dyslipidemia among US adults. JAMA 2010; 303: 1490–1497.

71. Kohli R., Bove K. E., Xanthakos S. A. Non-alcoholic fatty liver disease in children. In book: Edited by Suchy F. J., Sokol R. J., Balistreri W. F. Liver disease in children. Fourth edition © Cambridge University Press 2014: 631–648.

72. Isganaitis E., Lustig R. H. Fast food, central nervous system insulin resistance, and obesity. Arterioscler Thromb Vasc Biol 2005; 25: 2451–2462.

73. Pereira M. A., Kartashov A. I., Ebbeling C. B., et al. Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet 2005; 365: 36–42.

74. Lam T. K., Schwartz G. J., Rossetti L. Hypothalamic sensing of fatty acids. Nat. Neurosci. 2005; 8: 579–584.

75. Lustig R. H. Childhood obesity: behavioral aberration or biochemical drive? Reinterpreting the First Law of Thermodynamics. Nat. Clin. Pract. Endocrinol. Metab. 2006; 2: 447–458.

76. Anthony K., Reed L. J., Dunn J. T., et al. Attenuation of insulin evoked responses in brain networks controlling appetite and reward in insulin resistance: the cerebral basis for impaired control of food intake in metabolic syndrome? Diabetes 2006; 55: 2986–2992.

77. Vos M. D., Abrams S. H., Barlow S. E., et al. NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children: Recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). JPGN2017; 64: 319–334.

78. Lee S., Bacha F., Hannon T., et al. Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, and insulin sensitivity in obese adolescent boys: a randomized, controlled trial. Diabetes 2012; 61: 2787–2795.

79. Ramon-Krauel M., Salsberg S. L., Ebbeling C. B., et al. A low-glycemicload versus low-fat diet in the treatment of fatty liver in obese children. Child. Obes. 2013; 9: 252–260.

80. Jin R., Welsh J. A., Le N. A., et al. Dietary fructose reduction improves markers of cardiovascular disease risk in Hispanic-American adolescents with NAFLD. Nutrients 2014; 6: 3187–3201.

81. Campos R. M., De Piano A., Da Silva P. L., et al. The role of pro/anti-inflammatory adipokines on bone metabolism in NAFLD obese adolescents: effects of long-term interdisciplinary therapy. Endocrine 2012; 42: 146–156.

82. Koot B. G., Van der Baan-Slootweg O.H., TammingaSmeulders C.L., et al. Lifestyle intervention for non-alcoholic fatty liver disease: prospective cohort study of its efficacy and factors related to improvement. Arch. Dis. Child. 2011; 96: 669–674.

83. DeVore S., Kohli R., Lake K., et al. A multidisciplinary clinical program is effective in stabilizing BMI and reducing transaminase levels in pediatric patients with NAFLD. J. Pediatr. Gastroenterol. Nutr. 2013; 57: 119–123.

84. Sylvetsky A., Welsh J. A., Walsh S. M., Vos M. B. Actionoriented counseling attains weight stabilization and improves liver enzymes among overweight and obese children and adolescents. Open J. Pediatr. 2012; 2: 236–243.

85. Feldstein A. E., Treeprasertsuk S., Sha ra tcha roenwitthay A. P., et al. The natural history of nonalcoholic fatty liver disease in children: a follow-up study for up to 20 years. Hepatology 2008. vol. 48 (suppl): 335A p.

86. Ludwig D. S., Majzoub J. A., Al-Zahrani A., et al. High glycemic index foods, overeating, and obesity. Pediatrics 1999. vol. 103: E26 p.

87. Spieth L. E., Harnish J. D., Lenders C. M., et al. A low-glycemic index diet in the treatment of pediatric obesity. Arch. Pediatr. Adolesc. Med 2000. vol. 154, pp. 947–951.

88. Ebbeling C. B., Leidig M. M., Feldman H.A, et al. Effects of a low-glycemic load vs low-fat diet in obese young adults: a randomized trial. JAMA 2007. vol. 297, pp. 2092–2102.

89. De Ruyter J. C., Olthof M. R., Seidell J. C., et al. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N. Engl. J. Med. 2012. vol. 367, pp. 1397–1406.

90. Ebbeling C. B., Feldman H. A., Chomitz V. R., et al. A randomized trial of sugar-sweetened beverages and adolescent body weight. N. Engl. J. Med. 2012. vol. 367, pp. 1407–1416.

91. Force USPST, Barton M. Screening for obesity in children and adolescents: US Preventive Services Task Force recommendation statement. Pediatrics 2010. vol. 125, pp. 361–367.

92. Lavine J. E., Schwimmer J. B., Van Natta M. L., et al. Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents: the TONIC randomized controlled trial. JAMA 2011. vol. 305, pp. 1659–1668.

93. Schwimmer J. B., Middleton M. S., Deutsch R., et al. A phase 2 clinical trial of metformin as a treatment for non-diabetic paediatric nonalcoholic steatohepatitis. Aliment. Pharmacol. Ther. 2005. vol. 21, pp. 871–879.

94. Nadeau K. J., Ehlers L. B., Zeitler P. S., et al. Treatment of non-alcoholic fatty liver disease with metformin versus lifestyle intervention in insulin-resistant adolescents. Pediatr. Diabetes. 2009. vol. 10, pp. 5–13.

95. Freemark M. Liver dysfunction in paediatric obesity: a randomized, controlled trial of metformin. Acta Paediatr. 2007. vol. 96, pp. 1326–1332.

96. Nobili V., Manco M., Ciampalini P., et al. Metformin use in children with nonalcoholic fatty liver disease: an open-label, 24-month, observational pilot study. Clin. Ther. 2008. vol. 30, pp. 1168–1176.

97. Lavine J. E. Vitamin E treatment of nonalcoholic steatohepatitis in children: a pilot study. J. Pediatr. 2000. vol. 136, pp. 734–738.

98. Vajro P., Mandato C., Franzese A., et al. Vitamin E treatment in pediatric obesity-related liver disease: a randomized study. J. Pediatr. Gastroenterol. Nutr. 2004. vol. 38, pp. 48–55.

99. Nobili V., Manco M., Devito R., et al. Lifestyle intervention and antioxidant therapy in children with nonalcoholic fatty liver disease: a randomized, controlled trial. Hepatology. 2008. vol. 48, pp. 119–128.

100. Akcam M., Boyaci A., Pirgon O., et al. Therapeutic effect of metformin and vitamin E versus prescriptive diet in obese adolescents with fatty liver. Int. J. Vitam. Nutr. Res. 2011. vol. 81, pp. 398–406.

101. Vajro P., Franzese A., Valerio G., et al. Lack of efficacy of ursodeoxycholic acid for the treatment of liver abnormalities in obese children. J. Pediatr. 2000. vol. 136, pp. 739–743.

102. Nobili V., Bedogni G., Alisi A., et al. Docosahexaenoic acid supplementation decreases liver fat content in children with non-alcoholic fatty liver disease: double-blind randomised controlled clinical trial. Arch. Dis. Child. 2011. vol. 96, pp. 350–353.

103. Dasarathy S., Dasarathy J., Khiyami A., et al. Doubleblind randomized placebo-controlled clinical trial of omega 3 fatty acids for the treatment of diabetic patients with nonalcoholic steatohepatitis. J. Clin. Gastroenterol. 2015. vol. 49, pp. 137–144.

104. Alisi A., Bedogni G., Baviera G., et al. Randomised clinical trial: the beneficial effects of VSL#3 in obese children with non-alcoholic steatohepatitis. Aliment. Pharmacol. Ther. 2014. vol. 39, pp. 1276–1285.

105. Vajro P., Mandato C., Licenziati M. R., et al. Effects of Lactobacillus rhamnosus strain GG in pediatric obesity-related liver disease. J. Pediatr. Gastroenterol. Nutr. 2011. vol. 52, pp. 740–743.

106. Della Corte C., Liccardo D., Ferrari F., et al. Current pharmacotherapy for treating pediatric nonalcoholic fatty liver disease. Expert. Opin. Pharmacother. 2014, vol. 15, pp. 2501–2511.

107. Nobili V., Vajaro P., Dezsofi A., et al. Indications and limitations of bariatric intervention in severely obese children and adolescents with and without nonalcoholic steatohepatitis: ESPGHAN Hepatology Committee Position Statement. JPGN2015. vol. 60, pp. 550–556.

108. Holterman A. X., Guzman G., Fantuzzi G., et al. Nonalcoholic fatty liver disease in severely obese adolescent and adult patients. Obesity 2013. vol. 21, pp. 591–597.

109. Feldstein A. E., Charatcharoenwitthaya P., Treeprasertsuk S., et al. The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years. Gut 2009. vol. 58: 1538–1544.

110. Kelly A. S., Barlow S. E., Rao G., et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation 2013. vol. 128, pp. 1689–1712.


Рецензия

Для цитирования:


Власов Н.Н., Корниенко Е.А. Неалкогольная жировая болезнь печени и метаболический синдром в детском возрасте. Экспериментальная и клиническая гастроэнтерология. 2020;183(11):51-61. https://doi.org/10.31146/1682-8658-ecg-183-11-51-61

For citation:


Vlasov N.N., Kornienko E.A. Non-alcoholic fatty liver disease and metabolic syndrome in childhood. Experimental and Clinical Gastroenterology. 2020;183(11):51-61. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-183-11-51-61

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