Morphofunctional Сhanges of Gallbladder and Biochemical Parametеrs of Lipid Metabolism in Children with Liver Steatosis

Abstract

Background. The aim of study was to investigate peculiarities of structural and functional disorders of gallbladder in children with non-alcoholic fatty liver disease. Materials and methods. The study was conducted in 51 children aged 10–17 years. Patients were divided into four groups: the 1st group consisted of 11 children with biliary normokinesia without steatosis; the 2nd group — 20 children with biliary hypokinesia without steatosis; 3rd group — 11 children with biliary normokinesia and steatosis, and the 4th group — 9 children with biliary hypokinesia and steatosis. Anthropometric parameters were measured: height, weight, abdominal circumference, body mass index. Functional state of gallbladder was investigated with the help of ultrasound. Such biochemical parameters, as total cholesterol, triacylglycerols, levels of high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and very-low-density lipoprotein cholesterol were defined, atherogenic index was calculated according to Friedewald formula. Results. Present study shows overweight (in 15 % of patients), obesity (in 85 % of patients), increase in the gallbladder volume by 30–50 % (p < 0.05), in the density of gallbladder wall by 12–16 % (p < 0.05) and its echogenicity by 24 % (p < 0.05) in children with steatosis versus group without steatosis and gallbladder normokinesia. Positive correlation between wall thickness and steatosis has been established. Thus, weight increase may potentially play a role in lipid disorders and biliary dysfunction. The 70 % of children with obesity had pathological changes of lipid levels, such as 74 % — increased blood atherogenicity. Conclusions. Physicians must necessarily correct a functional state of gallbladder during the treatment of obesity in children and adolescents. Only comprehensive approach to the treatment allows prevention of non-alcoholic fatty liver disease and its complications.

Keywords

• biliary dysfunction
• steatosis
• obesity
• dyslipidemia