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

The Effect of Dietary Fat Intake on Fecal Elastase-1 Levels in Obese Children

نویسندگان :

Golnaz Khodayari¹ Nastaran Vakilbashi² Kiyanoush Jafari³ Faezeh Ghalichi⁴

1- دانشکده علوم پزشکی مراغه 2- دانشگاه علوم پزشکی شهید بهشتی 3- دانشکده علوم پزشکی مراغه 4- دانشکده علوم پزشکی مراغه

کلمات کلیدی :

Exocrine Pancreatic Insufficiency،Dietary Fat،Childhood Obesity،Fecal Elastase-1،Fat-Restricted Diet،Pediatric Nutrition

چکیده :

Background and Aim: Recent evidence has suggested a possible link between high-fat dietary intake and impaired exocrine pancreatic function in obese children. Fecal elastase-1 serves as a reliable, non-invasive biomarker for detecting exocrine pancreatic insufficiency (EPI). While EPI is commonly associated with malnutrition, emerging data indicate that subclinical pancreatic insufficiency may also occur in obese pediatric populations. This systematic review aims to examine the relationship between dietary fat intake and fecal elastase-1 levels in obese children. Material and Methods: A systematic search was conducted across PubMed, Scopus, and Web of Science for studies published between 2010 and 2024. Inclusion criteria were: studies involving children under 18 years with BMI ≥95th percentile, assessment of fecal elastase-1 levels, and evaluation of dietary fat intake or fat-modified interventions. Studies were screened and reviewed based on PRISMA guidelines. A total of 3 eligible studies were included in the final synthesis. Results: Karimi et al. (2019) evaluated 60 obese children undergoing an 8-week fat-restricted diet (20–25% of total energy intake from fat). The intervention resulted in a significant increase in mean fecal elastase-1 levels from 142 µg/g to 186 µg/g (p < 0.01), with parallel improvement in gastrointestinal symptoms. Santos et al. (2021) conducted a cross-sectional study on 112 obese children and found a significant inverse correlation between total fat intake and fecal elastase-1 levels (r = –0.37, p < 0.01). Children in the highest quartile of saturated fat intake were more likely to have enzyme levels below 200 µg/g. In a randomized clinical trial by Lee et al. (2023), 45 obese children were assigned to a low-fat diet group and a control group for 10 weeks. The low-fat group showed a mean increase of 41 µg/g in fecal elastase-1 levels, while the control group had no significant change. Conclusion: The reviewed studies suggest that high dietary fat intake, particularly saturated fats, may be associated with reduced exocrine pancreatic function in obese children, as indicated by lower fecal elastase-1 levels. Conversely, dietary fat restriction appears to improve enzyme activity and digestive symptoms. These findings support the integration of fat-modified nutritional strategies in the clinical management of obese children with suspected pancreatic dysfunction. Further well-designed longitudinal studies are warranted to confirm causality and explore underlying mechanisms.