Мать и дитя в Кузбассе (Nov 2023)
MICROBIOTIC INTESTINAL IMBALANCE IN CHILDREN WITH NON-ALCOHOLIC FATTY LIVER DISEASE
Abstract
The aim – to evaluate the frequency of small intestinal bacterial overgrowth and the level of systemic endotoxemia in children with non-alcoholic fatty liver disease. Materials and methods. 98 children with constitutionally exogenous obesity were examined in Donetsk City Children's Clinical Hospital N 1. Group 1 consisted of 60 children with non-alcoholic fatty liver disease. Group 2 included 38 obese children without signs of liver damage. The prevalence of small intestinal bacterial overgrowth and the systemic endotoxemia were determined in all patients. The control group consisted of 30 children with normal body weight. Results. Small intestinal bacterial overgrowth was detected in 72.4 ± 4.5 % of obese children, which was statistically significant (p < 0,001) more often than in children of the control group – 13.3 ± 6.2 %. In group 1, small intestinal bacterial overgrowth was detected in 55.3 8.1 %, and in group 2 – in 83.3 4.8 % (p < 0.01). In the control group, 93.3 4.6 % of children had a physiological level of endotoxemia (˂ 1,0 EU/мл), the average value of lipopolysaccharides in the group was 0.6 ± 0.1 EU/ml. Among obese patients, the majority had an increased concentration of lipopolysaccharides in the blood serum – 68.4 ± 4.7 %. In group 2, an increase in lipopolysaccharides in blood serum was found in 36.8 7.8 % of children, and in group 1 – in 88.0 4.2 % (p < 0.001). In group 1, the average value of lipopolysaccharides was 1.7 0.1 EU/ml, in group 2 – 1.0 0.1 EU/ml (p < 0.001). Conclusions. For patients with constitutionally exogenous obesity, the small intestinal bacterial overgrowth is characteristic. At the same time, in children with non-alcoholic fatty liver disease, microbiotic imbalance in the small intestine is recorded significantly more often than in obese patients without signs of liver damage. The small intestinal bacterial overgrowth in obese children occurs against the background of the development of systemic endotoxemia.
