A decline in aminotransferase activity due to lifestyle modification in children with NAFLD

INTRODUCTION: As obesity rates in children and adolescents increased, nonalcoholic fatty liver disease has become the most common liver disease affecting this organ. The study aimed at the evaluation of the effectiveness of lifestyle modifications as a method of improving the liver function indexes of children with nonalcoholic fatty liver disease.
METHODS: The study group consisted of 49 patients with nonalcoholic fatty liver disease (35 boys and 14 girls), age range 3-16 years (mean 10,51±3,18 years). The anthropometric measurements and laboratory tests were performed. Features of steatosis of the liver were evaluated by ultrasound. The mean follow-up period was 2,45±1,45 years. APRI (AST to Platelet Ratio) and PNFS (Pediatric NAFLD Fibrosis Score) were calculated. The Mediterranean diet and physical exercises have been recommended. End-point parameters were a decrease in aminotransferase level and body weight.
RESULTS: In the study group, 35 children (71.43%) were obese, and 7 (14.29%) were overweight. In 22/49 cases (44.9%) BMI loss was achieved, in the other patients BMI gain was noted. Abnormal ALT level was observed in 25/49 children. In the group of children with increased ALT level significant reduction of ALT, AST and GGT levels were found concerning baseline values (Table 2). There was also a significant decline in mean APRI level and PLT count. Moreover, a decrease in ALT level was negatively related to PNFS, APRI and GGT.
DISCUSSION AND CONCLUSION: Lifestyle modification has a significant effect on the decrease in aminotransferase levels, even in children who fail to achieve BMI reduction.