PMID- 19224892
OWN - NLM
STAT- MEDLINE
DCOM- 20090625
LR  - 20140730
IS  - 1468-2044 (Electronic)
IS  - 0003-9888 (Linking)
VI  - 94
IP  - 6
DP  - 2009 Jun
TI  - Lifestyle intervention in obese children with non-alcoholic fatty liver disease: 
      2-year follow-up study.
PG  - 437-42
LID - 10.1136/adc.2008.143594 [doi]
AB  - OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of 
      liver disease in obese youth. Lifestyle intervention was demonstrated to improve 
      NAFLD but follow-up studies after end of intervention are lacking. Furthermore 
      the necessary degree of overweight reduction for improvement of NAFLD remains 
      unknown. METHODS: We examined standard deviation score of body mass index 
      (SDS-BMI) and transaminases in 152 obese children with NAFLD diagnosed by 
      ultrasound at baseline, at the end of a 1-year intervention and 2 years after 
      baseline. Within-subject changes of these parameters were compared by 
      participation in the intervention based on physical activity, nutrition education 
      and behaviour therapy. RESULTS: In contrast to 43 children without lifestyle 
      intervention, participation in lifestyle intervention (n = 109) was associated 
      with a significant decrease of transaminases and overweight 1 and 2 years after 
      baseline (1 year: alanine transaminase (ALT) -10 U/l (-14 to -6); aspartate 
      transaminase (AST) -5 U/l (-7 to -3); SDS-BMI -0.23 (-0.30 to -0.16); 2 years: 
      ALT -9 U/l (-12 to -6); AST -6 U/l (-7 to -4); SDS-BMI -0.30 (-0.37 to -0.22); 
      data as mean changes and 95% confidence interval compared to baseline). Any 
      degree of overweight reduction was associated with a significant decrease of 
      NAFLD prevalence. The greatest decrease of NAFLD prevalence (1 year: -89% (95% CI 
      -72% to -100%); 2 years: -94% (95% CI -83% to -100%)) was observed in children 
      with the greatest overweight reduction (SDS-BMI decrease >0.5). CONCLUSIONS: 
      Multidisciplinary lifestyle intervention is effective to improve NAFLD even in 
      the 1-year follow-up after the end of intervention. A minimal reduction of 
      overweight led to an improvement of NAFLD. TRIAL REGISTRATION NUMBER: 
      NCT00435734.
FAU - Reinehr, T
AU  - Reinehr T
AD  - Vestische Hospital for Children and Adolescents, University of Witten-Herdecke, 
      Datteln, Germany. T.Reinehr@kinderklinik-datteln.de
FAU - Schmidt, C
AU  - Schmidt C
FAU - Toschke, A M
AU  - Toschke AM
FAU - Andler, W
AU  - Andler W
LA  - eng
SI  - ClinicalTrials.gov/NCT00435734
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090217
PL  - England
TA  - Arch Dis Child
JT  - Archives of disease in childhood
JID - 0372434
RN  - 0 (Blood Glucose)
RN  - EC 2.6.1.1 (Aspartate Aminotransferases)
RN  - EC 2.6.1.2 (Alanine Transaminase)
SB  - IM
MH  - Adolescent
MH  - Alanine Transaminase/metabolism
MH  - Anthropometry
MH  - Aspartate Aminotransferases/metabolism
MH  - Blood Glucose/metabolism
MH  - Body Mass Index
MH  - Child
MH  - Fatty Liver/etiology/metabolism/*therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Germany
MH  - Health Behavior
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Obesity/complications/metabolism/*therapy
MH  - Practice Guidelines as Topic
MH  - Risk Reduction Behavior
MH  - Time Factors
MH  - Weight Loss/physiology
EDAT- 2009/02/20 09:00
MHDA- 2009/06/26 09:00
CRDT- 2009/02/20 09:00
PHST- 2009/02/20 09:00 [entrez]
PHST- 2009/02/20 09:00 [pubmed]
PHST- 2009/06/26 09:00 [medline]
AID - adc.2008.143594 [pii]
AID - 10.1136/adc.2008.143594 [doi]
PST - ppublish
SO  - Arch Dis Child. 2009 Jun;94(6):437-42. doi: 10.1136/adc.2008.143594. Epub 2009 
      Feb 17.