Non-alcoholic fatty liver disease (NAFLD) has become the most prevalent chronic liver disease worldwide, paralleling the obesity pandemic. Secondary to increasing rates of obesity in children and adolescents, the prevalence of NAFLD has more than doubled in the last decades and is now the most common pediatric liver disease. At present, lifestyle modification by dietary intervention and increasing physical activity is the mainstay of treatment for pediatric NAFLD. Several studies have shown that lifestyle intervention and weight loss improve non-invasive markers of NAFLD. To the investigator's knowledge, data on fibrosis regression following lifestyle treatment in children and adolescents were lacking. The investigators therefore performed a prospective cohort study to investigate the impact of residential lifestyle treatment on liver steatosis and fibrosis in obese children and adolescents. As a follow-up, the investigators now aim to compare these findings with a cohort of well-characterized patients undergoing multidisciplinary, yet ambulatory, weight loss treatment. As such, the investigators will compare the outcomes in two prospective patient cohorts in this non-randomized observational study.
Study Type
OBSERVATIONAL
Enrollment
850
Increasing the level of physical activity, dietary intervention, acquiring healthy eating habits, and psychological support.
AZ Jan Palfijn
Ghent, East-Flanders, Belgium
RECRUITINGUniversity Hospital Gent
Ghent, East-Flanders, Belgium
RECRUITINGZeepreventorium
De Haan, West-Flanders, Belgium
RECRUITINGImprovement of liver fibrosis
Liver fibrosis will be quantified using Fibroscan, and patients will be divided into disease stages based on published cut-offs.
Time frame: 6 months of lifestyle intervention
Improvement of liver fibrosis
Liver fibrosis will be quantified using Fibroscan, and patients will be divided into disease stages based on published cut-offs.
Time frame: 12 months of lifestyle intervention
Improvement of liver steatosis
Liver steatosis will be quantified using controlled attenuation parameter on the Fibroscan
Time frame: 6 months of lifestyle intervention
Improvement of liver steatosis
Liver steatosis will be quantified using controlled attenuation parameter on the Fibroscan
Time frame: 12 months of lifestyle intervention
Resolution of liver steatosis
Liver steatosis will be quantified using controlled attenuation parameter on the Fibroscan. Resolution of steatosis is identified as CAP \<248 dB/m at follow-up in patients with baseline CAP of 248 dB/m or higher.
Time frame: 6 months of lifestyle intervention
Resolution of liver steatosis
Liver steatosis will be quantified using controlled attenuation parameter on the Fibroscan. Resolution of steatosis is identified as CAP \<248 dB/m at follow-up in patients with baseline CAP of 248 dB/m or higher.
Time frame: 12 months of lifestyle intervention
Resolution of liver fibrosis
Liver fibrosis will be quantified using Fibroscan. Resolution of fibrosis is identified as liver stiffness \<7.0 kPa at follow-up in patients with baseline liver stiffness of 7.0 kPa or higher.
Time frame: 6 months of lifestyle intervention
Resolution of liver fibrosis
Liver fibrosis will be quantified using Fibroscan. Resolution of fibrosis is identified as liver stiffness \<7.0 kPa at follow-up in patients with baseline liver stiffness of 7.0 kPa or higher.
Time frame: 12 months of lifestyle intervention
Improvement in ALT
Proportion of patients with at least 30% decrease in serum ALT levels at follow-up, out of the patients with baseline elevated ALT
Time frame: 6 months of lifestyle intervention
Improvement in ALT
Proportion of patients with at least 30% decrease in serum ALT levels at follow-up, out of the patients with baseline elevated ALT
Time frame: 12 months of lifestyle intervention
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