Obesity in children and adolescents: the relation between metabolic syndrome and non-alcoholic fatty-liver disease

摘要

This article aims to review clinical and diagnostic aspects of non-alcoholic fatty liver disease associated with obesity and its relation to metabolic syndrome in children and adolescents. An on-line search was carried out of original articles in the Medical Literature Analysis and Retrieval System Online (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Eletronic Library Online (SciELO) databases, using the following key words: "hepatic steatosis", "nonalcoholic fatty liver diseases", "overweight", "obesity", "children", "adolescents", "ultrasound" and "metabolic syndrome" in English and Portuguese. Two hundred and seventy-five articles were initially selected, all published between 1993 and 2008. After reading this was narrowed down to 67. The literature consulted revealed no consensus regarding the need to screen for metabolic syndrome and non-alcoholic fatty liver disease, especially in obese children and adolescents and those who have excess fat in the abdominal region. An ultrasound examination of the liver is typically used for screening and, in the case of children who present alterations in aminotransferases in addition to fatty infiltration of the liver, a strict clinical follow-up and a liver biopsy are recommended if these symptoms do not disappear on treatment.