Conduct disorder

Novini vo pedijatrijata / Godi[na revija 2009
na vitamin E sé u[te ne e dovolno jasna, a od metforminot se o~ekuvaat povolni
rezultati vo bliska idnina. Isto taka ulogata na bariatri~na hirurgija
sé u[te ne e dovolno definirana. Bidej]i ishodot mo`e da bide te-
`ok, a tretmanot relativno neefikasen, primarnata prevencija na nealkoholnata
mastna bolest na crniot drob treba da bide od a priori karakter
vo pedijatriskata populacija.
Literatura: Na raspolagawe kaj avtorot
NON-ALCHOCOLIC FATTY LIVER DISEASE
Kostovski A
University Childrten Hospital Skopje
Steatosis is characterized by accumulation of fat in hepatocytes.
In adults it’s mostly caused by the alcoholic liver disease. Hepatic steatosis is a
very rare condition in childhood. In pediatric patients hepatic steatosis is present
in some metabolic diseases, after using some drugs, and more frequently in
obese children. In obese children is known as Nonalcoholic fatty liver disease
(NAFLD).
In the introduction the main characteristics of the NAFLD in adults are given.
After that the main pathophysiologic factors are presented. Among the others
the main roles have insulin resistance and hyperinsulinemia. Further on disturbances
of the metabolism of glucose and lipids are explained (mobilization of
free fatty acids ; decreased beta oxidation ; adipocytokines - TNF-α, adiponectin,
resistin ; hypertrigliceridemia, leptin and genetic factors).
Prevalence of NAFLD in childhood is disclosed in some epidemiologic studies,
from different regions of the world.
Some other metabolic and genetic diseases may also present NAFLD: Alström
Syndrome, Bardet-Biedl Syndrome, Polycistic ovarial Syndrome, Turner Syndrome,
Lypodistrophy, mulibery namism etc.
Diagnostic approach and diferential diagnosis are discussed.
Treatment is multidisciplinary with control of obesity and insulin resistance (with
metformin, tiazolidinediones, ursodeoxycholic acid, Vit E) and diminishing of oxidative
stress. Since the outcome may be severe and treatment may prove relatively
ineffective, primary prevention of NAFLD should be a priority at pediatric
age.
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