سامانه کنگره های دانشگاه علوم پزشکی و خدمات بهداشتی و درمانی آذربایجان غربی

صفحه اصلی / بیستمین همایش سالیانه بیماری های شایع گوارش و کبد کودکان ایران و دومین همایش بین المللی چاقی کودکان

Pharmacological Interventions for Obesity in Children with Asymptomatic Fatty Liver Disease

نویسندگان :

Samaneh Sepahi¹ Sakineh Nouri Saeidlou² Mohammad Yousefi³

1- دانشگاه علوم پزشکی ارومیه 2- دانشگاه علوم پزشکی ارومیه 3- دانشگاه علوم پزشکی ارومیه

کلمات کلیدی :

Pediatric obesity،NAFLD،Pharmacotherapy،GLP-1 agonists،Weight management

چکیده :

Abstract Background and Aim: The growing issue of childhood obesity has been linked to a rise in non-alcoholic fatty liver disease (NAFLD). This condition often doesn’t show symptoms in its early stages, but it can progress to more serious issues like steatohepatitis (NASH) and cirrhosis. While obesity is the main modifiable risk factor, lifestyle changes alone often fall short in achieving lasting weight loss or improving liver health. This review looks into how pharmacological treatments can help manage obesity and slow down the progression of NAFLD in children. Methods: We conducted a narrative synthesis of literature from 2015 to 2024, utilizing databases like PubMed, Cochrane, and Scopus. Our focus was on randomized controlled trials (RCTs), meta-analyses, and guidelines that discuss FDA/EMA-approved or investigational drugs (such as orlistat, liraglutide, and metformin) for treating obesity in children aged 6 to 18 with NAFLD. We gathered data on effectiveness (like BMI reduction, liver enzyme levels, and imaging/histology) and safety. Results: Orlistat, which works as a lipase inhibitor, resulted in modest BMI reductions of about 2-3%, but it offered limited benefits for the liver and often caused gastrointestinal side effects. On the other hand, GLP-1 agonists, like liraglutide, showed better results, with trials indicating a 5-10% reduction in BMI and improvements in ALT levels and steatosis scores for some patients. Metformin produced mixed outcomes, while newer treatments like SGLT-2 inhibitors have shown promise in adult studies but lack solid evidence for children. Combination therapies, such as phentermine/topiramate, are still not well-studied in pediatric populations. Conclusion: Pharmacological treatments, especially GLP-1 agonists, could be a valuable addition to lifestyle changes for obese children dealing with NAFLD, although we still need more data on their long-term safety and effectiveness. It’s crucial to create personalized treatment plans and have multidisciplinary monitoring in place. Future RCTs should focus on protocols tailored for children and include histological endpoints.

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