12
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Cholelithiasis in obese adolescents treated at an outpatient clinic , Translated title: Litíase biliar em adolescentes obesos atendidos em ambulatório ,

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          OBJECTIVE:to describe the frequency and the factors associated with cholelithiasis in obese adolescents.METHODS:this was a cross-sectional descriptive study performed with the adolescents between 10 and 19 years of age treated at the Child and Adolescent Obesity Outpatient Clinic from May to December of 2011. Obesity was defined as body mass index (BMI) > P97, and overweight as BMI > P85, for age and gender, according to the 2007 World Health Organization reference. A questionnaire concerning the presence of signs and symptoms, such as abdominal pain, nausea, vomiting, and intolerance to fat, was administered. Patients were asked about how many kilograms they had lost and in how much time. Laboratory parameters were: triglycerides, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels. Cholelithiasis and hepatic steatosis were diagnosed by ultrasonography.RESULTS:cholelithiasis was diagnosed in 6.1% (4/66) of the obese adolescents, most of whom were female (3/4); hepatic steatosis was identified in 21.2% (14/66). Intolerance to dietary fat was reported by all patients with cholelithiasis (4/4) and by 17.7% (11/62) of the group without cholelithiasis (p = 0.001). The average weight loss was 6.0 ± 2.9 kg in the patients with cholelithiasis and 3.2 ± 4.8 kg in the group without cholelithiasis (p = 0.04). However, there was no difference between the two groups regarding the time of weight loss (p = 0.11).CONCLUSIONS:cholelithiasis and hepatic steatosis are frequent among obese adolescents and should be investigated systematically in the presence or absence of symptoms.

          Translated abstract

          OBJETIVO: descrever a frequência e os fatores associados à litíase biliar em adolescentes obesos.MÉTODOS: estudo descritivo tipo corte transversal com adolescentes entre 10 e 19 anos atendidos em ambulatório de obesidade infanto-juvenil, no período de maio a dezembro de 2011. A obesidade foi definida como índice de massa corporal > P97 e o sobrepeso > P85, para idade e sexo, segundo o referencial OMS 2007. Foi aplicado um questionário com dados relacionados à presença de sinais e sintomas, como: dor abdominal, náusea, vômito e intolerância à gordura. Os pacientes foram questionados sobre quantos quilos perderam e em quanto tempo. As variáveis laboratoriais foram: triglicerídeos, colesterol total, lipoproteína de alta densidade (HDL) e lipoproteína de baixa densidade (LDL), aspartato aminotransferase (AST) e alanina aminotransferase (ALT). A litíase biliar e a esteatose hepática foram diagnosticadas por ultrassonografia.RESULTADOS: a litíase biliar foi diagnosticada em 6,1% (4/66) dos adolescentes obesos, a maioria do sexo feminino (3/4); a esteatose hepática foi identificada em 21,2% (14/66). Intolerância à gordura da dieta foi referida por todos os portadores de litíase biliar (4/4) e por 17,7% (11/62) do grupo sem litíase biliar (0,001). A média de perda de peso foi de 6,0 ± 2,9 kg nos pacientes com litíase biliar e 3,2 ± 4,8 kg no grupo sem litíase biliar (p = 0,04). Porém, em relação ao tempo de perda não houve diferença entre os dois grupos (p = 0,11).CONCLUSÕES: a litíase biliar e a esteatose hepática são frequentes entre adolescentes obesos e devem ser investigadas sistematicamente na presença ou ausência de sintomas.

          Related collections

          Most cited references26

          • Record: found
          • Abstract: found
          • Article: not found

          Metabolic syndrome in childhood predicts adult cardiovascular disease 25 years later: the Princeton Lipid Research Clinics Follow-up Study.

          The goal was to assess the association of metabolic syndrome in childhood with adult cardiovascular disease 25 years later. Data from the National Heart, Lung, and Blood Institute Lipid Research Clinics Princeton Prevalence Study (1973-1976) and the Princeton Follow-up Study (2000-2004) were used. BMI was used as the obesity measure in childhood, because waist circumference was not measured in the Lipid Research Clinics study. The adult cardiovascular disease status of participants and their parents was obtained through participant report. A logistic analysis was used to predict adult cardiovascular disease; pediatric metabolic syndrome, age at the Princeton Follow-up Study, gender, race, and parental history of cardiovascular disease were potential explanatory variables. Ages ranged from 6 to 19 years in the Lipid Research Clinics study and from 30 to 48 years in the Princeton Follow-up Study. There were 17 cases of cardiovascular disease in the analysis cohort in the Princeton Follow-up Study. Pediatric metabolic syndrome and age at follow-up assessment were significant predictors of cardiovascular disease. Pediatric metabolic syndrome and changes in age-specific BMI percentile from childhood to adulthood were significant predictors of adult metabolic syndrome. Evaluating children for metabolic syndrome could identify patients at increased risk of adult cardiovascular disease, making targeted interventions possible.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Asymptomatic cholelithiasis: is cholecystectomy really needed? A critical reappraisal 15 years after the introduction of laparoscopic cholecystectomy.

            Asymptomatic cholelithiasis is increasingly diagnosed today, mainly as a result of the widespread use of abdominal ultrasonography for the evaluation of patients for unrelated or vague abdominal complaints. About 10-20% of people in most western countries have gallstones, and among them 50-70% are asymptomatic at the time of diagnosis. Asymptomatic gallstone disease has a benign natural course; the progression of asymptomatic to symptomatic disease is relatively low, ranging from 10-25%. The majority of patients rarely develop gallstone-related complications without first having at least one episode of biliary pain ("colic"). In the prelaparoscopy era, (open) cholecystectomy was generally performed for symptomatic disease. The minimally invasive laparoscopic cholecystectomy refueled the discussion about the optimal management of asymptomatic cholelithiasis. Despite some controversy, most authors agree that the vast majority of subjects should be managed by observation alone (expectant management). Selective cholecystectomy is indicated in defined subgroups of subjects, with an increased risk for the development of gallstone-related symptoms and complications. Concomitant cholecystectomy is a reasonable option for good-risk patients with asymptomatic cholelithiasis undergoing abdominal surgery for unrelated conditions. Routine cholecystectomy for all subjects with silent gallstones is a too aggressive management option, not indicated for most subjects with asymptomatic cholelithiasis. An in-depth knowledge of the natural history of gallstone disease is required to select the optimal management option for the individual subject with silent gallstones. Management options should be extensively discussed with the patient; he or she should be actively involved in the process of therapeutic decision making.
              Bookmark
              • Record: found
              • Abstract: not found
              • Article: not found

              Health, United States, 2011 with Special Feature on Socioeconomic Status and Health

                Bookmark

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                jped
                Jornal de Pediatria
                J. Pediatr. (Rio J.)
                Sociedade Brasileira de Pediatria (Porto Alegre )
                1678-4782
                April 2014
                : 90
                : 2
                : 203-208
                Affiliations
                [1 ] Universidade Federal da Bahia Brazil
                [2 ] Universidade Federal de Campina Grande Brazil
                [3 ] Universidade Estadual de Campinas Brazil
                [4 ] Universidade Estadual da Paraíba Brazil
                [5 ] Universidade Federal da Bahia Brazil
                Article
                S0021-75572014000200203
                10.1016/j.jped.2013.08.008
                63c27631-d843-43b9-a589-b3ea4bf31a16

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0021-7557&lng=en
                Categories
                PEDIATRICS

                Pediatrics
                Obesity,Cholelithiasis,Hepatic steatosis,Children,Adolescent,Obesidade,Litíase biliar,Esteatose hepática,Criança,Adolescente

                Comments

                Comment on this article