Open AccessA Multidisciplinary Clinical Program Is Effective in Stabilizing BMI and Reducing Transaminase Levels in Pediatric Patients With NAFLD
Author(s) -
DeVore Stephanie,
Kohli Rohit,
Lake Kathleen,
Nicholas Lynda,
Dietrich Kim,
Balistreri William F.,
Xanthakos Stavra A.
Publication year - 2013
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0b013e318290d138
Subject(s) - medicine , nonalcoholic fatty liver disease , alanine transaminase , aspartate transaminase , weight loss , alanine aminotransferase , liver disease , multidisciplinary approach , gastroenterology , obesity , pediatrics , fatty liver , disease , alkaline phosphatase , social science , biochemistry , chemistry , sociology , enzyme
Background and Aim: Weight loss is an effective treatment for children with nonalcoholic fatty liver disease (NAFLD), but it is extremely difficult to achieve outside of an intensive weight management program. We hypothesized that one can achieve success in improving NAFLD and weight‐related outcomes in a structured and focused multidisciplinary clinical program feasible to implement in a gastroenterology clinic. Methods: We prospectively tracked the clinical status of our patients enrolled in a multidisciplinary program of dietary and exercise advice through an institutional review board–approved NAFLD registry. Each patient met with a gastroenterologist and dietitian every 3 months for 30 minutes to set individualized goals and monitor progress. Results: A total of 108 children have been enrolled in the registry, and of the 83 that were eligible for 1‐year follow‐up and included in the analysis, 39 patients returned, resulting in a 47% follow‐up rate. These 39 patients showed statistically significant improvements in mean BMI z score (−0.1 U, P < 0.05), total (−11 mg/dL, P < 0.05) and low‐density lipoprotein (9 mg/dL, P < 0.05) cholesterol, and serum alanine aminotransferase levels (−36 U/L) and aspartate aminotransferase levels (−22 U/L) levels. Conclusions: A clinically feasible multidisciplinary program for obese pediatric patients with NAFLD stabilized BMI z score and significantly improved aminotransferase levels at 1‐year follow‐up.