Probiotic and Lifestyle Modification in Obese Pediatrics with Non-Alcoholic Fatty Liver Disease
DOI:
https://doi.org/10.47203/IJCH.2019.v31i01.009Keywords:
NAFLD, Probiotic, Lifestyle modification, Obese ChildrenAbstract
Background: Non alcoholic fatty liver disease is an upcoming causes of chronic liver disease in pediatric population in Asia. Aims & Objective: To evaluate the potential of probiotic VSL#3 and Lifestyle modification in obese pediatrics with Non alcoholic fatty liver disease (NAFLD). Material & Methods: we conducted clinical trial in 106 obese children in age group of 5 to18 years and divided in to four groups;VSL#3 plus lifestyle intervention (n=26), VSL#3 (n=27), Lifestyle intervention (n=26) and Placebo (n=27) received interventions for four months. To identify NAFLD by ultrasonography, Body mass index (BMI), mid arm circumference (MAC), waist circumference (WC) and triceps skinfold thickness (TSF) were done. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), low-density lipoprotein cholesterol(LDL-c),high-density lipoprotein cholesterol (HDL-c), triglyceride (TG), cholesterol, fasting blood glucose(FBG), high sensitivity C-reactive protein (HSCRP), uric acid, obesity hormones were measured along with their dietary intake at baseline and post trial. Results: VSL#3 plus lifestyle intervention significantly the most pronounced therapy for reducing fatty liver grades, anthropometric with biochemical parameters and beneficial impact on obesity hormones (p<0.001) as compared to single therapy of VSL#3 and lifestyle intervention alone. Conclusion: Combined therapy of VSL#3 plus lifestyle intervention is promising treatment for management of NAFLD in Indian obese children.
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References
Alisi A, Ceccarelli S, Panera N, Nobili V. Causative role of gut microbiota in non-alcoholic fatty liver disease pathogenesis. Cellular and infection microbiology 2012; 2:1:132.
Parekh P.J, Balart L.A, Johnson DA. The influence of the gut micro biome on obesity, metabolic syndrome and gastrointestinal disease. Clinical and Translational gastroenterology 2015;6:91.
Paolella G, Mandato C, Pierri L, Poeta M, Di Stasi M, Vajro P. Gut-liver axis and probiotics: their role in non-alcoholic fatty liver disease. World J Gastroenterol. 2014 Nov 14;20(42):15518-31. doi: 10.3748/wjg.v20.i42.15518. Review. PubMed PMID: 25400436; PubMed Central PMCID: PMC4229517.[PubMed].
Alisi A, Bedogni G, Baviera G ,Giorio V, Porro E,Paris C, et al. Randomised clinical trial: the beneficial effects of VSL#3 in obese children with non-alcoholic steatohepatitis.AlimentPharmacolTher 2014;39(11):1276–85.
Nobili V, Alisi A, Raponi M. Pediatric non-alcoholic fatty liver disease: Preventive and therapeutic values of lifestyle intervention. World J Gastroenterol 2009;15:6017-22.
Body Mass Index (BMI) for age Reference Data (5-19years) girls and boys, 2007 WHO Reference. http://www.who.int/growthref/who2007_bmi_for_age/en/.
Jonathan A, Kimberly P, Jeffery B, et al. Lifestyle interventions including nutrition, exercise and supplements for nonalcoholic fatty liver disease in children. Dig Dis Sci 2016;61:1375-86.
Ma YY, Li L, Yu CH, Shen Z, Chen LH, Li YM. Effects of probiotics on nonalcoholic fatty liver disease: a meta-analysis. World J Gastroenterol. 2013 Oct 28;19(40):6911-8. doi: 10.3748/wjg.v19.i40.6911. Review. PubMed PMID: 24187469; PubMed Central PMCID: PMC3812493.[PubMed].
He J, Zhang F, Han Y. Effect of probiotics on lipid profiles and blood pressure in patients with type 2 diabetes: A meta-analysis of RCTs. Medicine (Baltimore). 2017 Dec;96(51):e9166. doi: 10.1097/MD.0000000000009166. Review. PubMed PMID: 29390450; PubMed Central PMCID: PMC5758152.[PubMed].
Famouri F, Shariat Z, Hashemipour M, Keikha M, Kelishadi R. Effects of Probiotics on Nonalcoholic Fatty Liver Disease in Obese Children and Adolescents. J Pediatr Gastroenterol Nutr. 2017 Mar;64(3):413-417. doi: 10.1097/MPG.0000000000001422. PubMed PMID: 28230607.[PubMed].
J.W Anderson and S.E. Gilliland. Effect of fermented milk (yoghurt) containing Lactobacillus acidophilus L1 on serum cholesterol in hypercholesterolemic humans. Journal of the American College of Nutrition 1999;18:43-50.
Kiessling G, Schneider J, Jahreis G. Long term consumption of fermented dairy products over 6 months increase HLD cholesterol. European Journal of Clinical Nutrition 2002;56:843-849.
Bukowska H, Pieczul-Mroz J, Jastrzebska M, Che?stowski K, Naruszewicz M. Decrease in fibrinogen and LDL- cholesterol levels upon supplementation of diet with lactobacillus plantarum in subjects with moderately elevated cholesterol. Atheresclerosis.1989;137(2):437-438.
Rajkumar H, Mahmood N, Kumar M, Varikuti SR, Challa HR, Myakala SP. Effect of probiotic (VSL#3) and omega-3 on lipid profile, insulin sensitivity, inflammatory markers, and gut colonization in overweight adults: a randomized, controlled trial. Mediators Inflamm. 2014;2014:348959. doi: 10.1155/2014/348959. Epub 2014 Mar 26. PubMed PMID: 24795503; PubMed Central PMCID: PMC3984795.[PubMed].
Yadav H, Lee JH, Lloyd J, Walter P, Rane SG. Beneficial metabolic effects of a probiotic via butyrate-induced GLP-1 hormone secretion. J Biol Chem. 2013 Aug 30;288(35):25088-97. doi: 10.1074/jbc.M113.452516. Epub 2013 Jul 8. PubMed PMID: 23836895; PubMed Central PMCID: PMC3757173.[PubMed].
Pannacciulli N, Bunt J, Koska, J, Bogardus C, Krakoff J. Higher fasting plasma concentrations of glucagon-like peptide 1 are associated with higher resting energy expenditure and fat oxidation rates in human. The Am J of clinical Nutr. 2006;84(3):556-60.
Behrouz V, Jazayeri S, Aryaeian N, Zahedi MJ3, Hosseini F. Effects of probiotic and prebiotic supplementation on leptin, adiponectin and glycemic parameters in non-alcoholic fatty liver disease: A Randomized Clinical Trial. Middle East JDig Dis. 2017;9(3):150-57.
Wang CL, Liang L, Fu JF,Zou CC,Hong F,Xue JZ, et al. Effect of lifestyle intervention on non-alcoholic fatty liver disease in Chinese obese children. World J Gastroenterol.l 2008;14(10):1598-1602.
Hernaez R, Lazo M, Bonekamp S, Kamel I, Brancati FL, Guallar E, Clark JM. Diagnostic accuracy and reliability of ultrasonography for the detection of fatty liver: a meta-analysis. Hepatology. 2011 Sep 2;54(3):1082-1090. doi: 10.1002/hep.24452. PubMed PMID: 21618575; PubMed Central PMCID: PMC4197002.[PubMed].
Fitzpatrick E, Mitry RR, Quaglia A, Hussain MJ, DeBruyne R, Dhawan A. Serum levels of CK18 M30 and leptin are useful predictors of steatohepatitis and fibrosis in paediatric NAFLD. J Pediatr Gastroenterol Nutr. 2010 Oct;51(4):500-6. doi: 10.1097/MPG.0b013e3181e376be. PubMed PMID: 20808246.[PubMed].
Goyal P, Thapa BR, Sharma, NR, Bhatia A. Nutritionall assessment in obese children with and without non-Alcoholic fatty liver disease (NAFLD) in an urban area of Punjab,India.Indian journal of Public Health Research and Development.2018;9:222-228.
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