sdü tıp fak derg

Medical Journal of Süleyman Demirel University

2602-2109

Süleyman Demirel Üniversitesi

10.17343/sdutfd.1209036

Clinical Sciences

Klinik Tıp Bilimleri

OBEZ ADOLESANLARDA YAĞLI KARACİĞER HASTALIĞININ PORTAL VEN AKIMINA ETKİSİ

THE EFFECT OF FATTY LIVER DISEASE ON PORTAL VEIN FLOW IN OBESE ADOLESCENTS

https://orcid.org/0000-0002-8820-8003

Aydınoğlu

Ayşe

SULEYMAN DEMIREL UNIVERSITY, SCHOOL OF MEDICINE, MEDICINE PR.

https://orcid.org/0000-0002-9153-8580

Atar

Müge

SULEYMAN DEMIREL UNIVERSITY, SCHOOL OF MEDICINE, MEDICINE PR.

https://orcid.org/0000-0003-4704-4759

Aydın

Hüseyin

SULEYMAN DEMIREL UNIVERSITY, SCHOOL OF MEDICINE, MEDICINE PR.

https://orcid.org/0000-0002-1729-2834

Pirgon

Özgür

SULEYMAN DEMIREL UNIVERSITY, SCHOOL OF MEDICINE, MEDICINE PR.

09 23 2023

30 3 294 300 11 23 2022 08 11 2023

1994

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

AmaçÇocuklarda obezitenin artması, nonalkolik yağlı karaciğerhastalığının pediatrik yaş grubunda en önemlikronik karaciğer hastalığı haline gelmesine nedenolmuştur. Bu çalışmada alkolik olmayan karaciğeryağlanması (NAFLD) olan obez çocuklarda portal vençapı ve kan akım hızını değerlendirmesi ve normalsağlıklı çocuklarla karşılaştırması amaçlanmıştır.Gereç ve Yöntem10-18 yaş arası 71 obez adolesan hasta, transaminazyüksekliği ve ultrasonda hepatosteatoz (NAFLD grubuve NAFLD olmayan grup) varlığına göre iki grubaayrıldı. Kontrol grubu olarak 30 sağlıklı ergen çalışmayadahil edildi. Her hastadan açlık glukozu, insülin,transaminaz düzeyleri ve tiroid fonksiyonları için kanörnekleri alındı. İnsülin direnci HOMA indeksi kullanılarakhesaplandı. Portal ven ölçümleri, bifurkasyonöncesi ana portal venden yapıldı.BulgularNAFLD grubunda portal ven çapı (8.5 ± 0.9 mm) hemkontrol grubuna (7.8 ± 2.0 mm) hem de NAFLD olmayanobez gruba (7.6 ± 1.1 mm) göre istatistikselolarak anlamlı derecede geniş olarak saptandı (p=0.004) ve (p=0.002). NAFLD olmayan obez grup ilekontrol grubu arasında anlamlı fark yoktu (p=0.460,p=0.214). Portal ven Vmax, Vmin, RI, S/D açısındangruplar arasında anlamlı fark yoktu. İnsülin direncinegöre sınıflandırılan obez gruplarda portal ven çaplarındafarklılık olmamasına rağmen, Vmax (33.9 ± 10.3ve 28.6 ± 10.6 cm/sn, p= 0.03) ve Vmin (24.8 ± 6.2ve 20.5 ± 5.5 cm/sn) insülin direnci grubunda önemliölçüde farklıydı.SonuçBu çalışmada NAFLD olan obez adolesanlarda portalven çapı ve akım hızlarının (Vmax ve Vmin) arttığıbelirlendi. Bu nedenle özellikle ergenlik dönemindeinsülin direnci olan obez hastalarda hepatik portal vensteatozuna bağlı hepatik venöz akımda direnç geliştiğidüşünüldü. Bu bulgu, karaciğer yağlanmasınındevam etmesi durumunda erişkin dönemde portal çapınınartacağını ve bunun da portal hipertansiyona yolaçacağını düşündürmektedir.

ObjectiveThe increase in obesity in children has causednonalcoholic fatty liver disease to become the mostimportant chronic liver disease in the pediatric agegroup. In this study, we aimed to evaluate the portaldiameter and blood flow velocity in obese children withfatty liver (NAFLD) and to compare them with normalhealthy children.Material and Method71 obese adolescent patients aged 10-18 years weredivided into two groups (NAFLD group and non-NAFLD group) according to the presence of elevatedtransaminases and the presence of hepatosteatosison ultrasound. 30 healthy adolescents were includedin the study as the control group. Blood sampleswere taken from each patient for fasting glucose,insulin, transaminases, and thyroid functions. Insulinresistance was calculated using the HOMA index.Portal vein measurements were performed from themain portal vein before bifurcation.ResultsThe portal vein diameter (8.5 ± 0.9 mm) of the NAFLDgroup was statistically significantly wide comparedto both the control group (7.8 ± 2.0 mm) and thenon-NAFLD obese group (7.6 ± 1.1 mm) (p= 0.004)and (p= 0.002). There was no significant differencebetween the non-NAFLD obese group and the controlgroup (p=0.460, p=0.214). There was no significantdifference between the groups in terms of portal veinVmax, Vmin, RI, S/D. Although there was no differencein portal vein diameter in the obese groups classifiedaccording to insulin resistance, Vmax (33.9 ± 10.3 and28.6 ± 10.6 cm/sec, p= 0.03) and Vmin (24.8 ± 6.2 and20.5 ± 5.5 cm/sec) were significantly different in theinsulin resistance group.ConclusionIn this study, it was determined that portal vein diameterand flow velocities (Vmax and Vmin) increased inobese adolescents with NAFLD. Thus, we suggestthat resistance develops in hepatic venous flow dueto hepatic portal vein steatosis, especially in obesepatients with insulin resistance in adolescence. Thisfinding suggests that when fatty liver continues, portaldiameter will increase in adulthood, leading to portalhypertension.

obesity hepatosteatosis doppler ultrasonography

obezite hepatosteatoz doppler ultrasonografi

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