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Title Esteatose hepática em crianças e adolescentes com fibrose cística: Hepatic steatosis in children and adolescents with cystic fibrosis
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Date Accessioned
University/Publisher Universidade Estadual de Campinas
Abstract Abstract: Cystic fibrosis (CF), is an autosomal recessive genetic disorder characterized by the dysfunction of the cystic fibrosis transmembrane conductance regulator gene (CFTR). It is considered a potentially lethal and multisystemic disease because it affects sweat glands, pancreas, lungs, liver, intestine and Wolff's ducts. Recently, attention has been paid to hepatic involvement in cystic fibrosis (CF), since it is the third leading cause of death after respiratory failure and complications related to lung transplant. Objectives: To determine the prevalence of hepatic steatosis (HS) in children and adolescents with CF and to associate it with the nutritional status. To associate HS and the nutritional status with the metabolic profile in children and adolescents with cystic fibrosis. Methods: Cross-sectional study in children and adolescents with CF diagnosis. Weight and height were checked for the calculation of BMI/age and classification of the nutritional status classified according to the cut-off points of the WHO and the International Consensus of CF. Arm circumference (AC), triceps skinfold (TSF) and arm muscle circumference (AMC) were used to evaluate body composition. Abdominal ultrasonography was performed for the diagnosis of HS. The metabolic profile was assessed by aminotransferase activity, lipid profile, triglycerides, fasting glycemia and basal insulin for calculating the HOMA index. The statistical tests used were the Student's t-test, Mann-Whitney, Chi-square and Anova, with a significance level of 5%. Results: Of the 50 patients evaluated, between the ages of 2 and 19 y.o. (incomplete) (12.28 ± 4.96), 18 (36%) presented HS (Group A) and 32 (64%) without HS. For the mean age (Group A = 13.3 ± 5.0 years and Group B = 11.7 ± 5.0 years), BMI (Group A = 18.0 ± 4.1 and Group B = 15.7 ± 3 , 8) and TSF (Group A = 8.4mm ± 3.5 and Group B = 7.0mm ± 2.5), there was no significant difference between the groups. Mean AC and AMC differed significantly between the groups, being higher in the group with HS with a respective p value of 0.047 and 0.043. Patients in group A presented a higher mean aspartate aminotransferase (AST) (p 0.034) and 61.1% of this group had elevated levels of alkaline phosphatase (ALP) (p 0.012). In this same group, mean total cholesterol and HDL were decreased (p = 0.029 and 0.018, respectively. The association between nutritional status classification and metabolic profile was not significant. Conclusion: The frequency of HS is high in patients with CF and is not related to malnutrition according to the parameters of BMI, TSF and AMC. AC and AMC values indicated a greater reserve of muscle mass in patients with HS. HS and metabolic profile in CF patients were not associated with nutritional status. HS was associated with elevation of ALP and AST. In the HS group, the patients presented lower mean HDL-cholesterol and total cholesterol
Subjects/Keywords Fibrose cística; Fígado gorduroso; Estado nutricional; Cystic fibrosis; Hepatic steatosis; Nutricional status
Contributors UNIVERSIDADE ESTADUAL DE CAMPINAS (CRUESP); Hessel, Gabriel, 1960- (advisor); Universidade Estadual de Campinas. Faculdade de Ciências Médicas (institution); Programa de Pós-Graduação em Saúde da Criança e do Adolescente (nameofprogram); Mendes, Roberto Teixeira (committee member); Toro, Adyléia Aparecida Dalbo Contrera (committee member); Merhi, Vania Aparecida Leandro (committee member); Saron, Margareth Lopes Galvão (committee member)
Language português
Country of Publication br
Record ID oai:repositorio.unicamp.br:REPOSIP/333752
Repository unicamp
Date Indexed 2020-09-09
Issued Date 2019-01-01 00:00:00
Note [] Orientador: Gabriel Hessel; [] Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas; [degreelevel] Doutorado; [degreediscipline] Saude da Criança e do Adolescente; [degreename] Doutora em Ciências; [sponsordocumentnumber] 02-P-4583/2018; [sponsor] CAPES;

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