Evaluation of the effect of decreased levels of high density lipoprotein cholesterol (HDL-C) on hepatosteatosis using Doppler and B-Mode ultrasonography in prepubertal and pubertal obese children

The aim: to evaluate the frequency of asymptomatic fatty liver disease (FLD) using both Doppler and B-mode ultrasound (US) in obese prepubertal and adolescents patients; (2) to compare anthropometric indices and metabolic findings of obese patients assessed by two methods; and to evaluate metabolic predictors of FL shown by these methods.Patient Selection & Method: Ninety-seven obese prepubertal(48 male, 49 female ) and one hundred-fourteen adolescents (63female, 51 male) were included in the study. B-mode and right hepatic vein Doppler ultrasonography (US) were performed and anthropometric indices, lipid profiles, and OGTT levels were evaluated in all obese patients.Correlation between biochemical findings with antropometric indices and ultrasonografic method were evaluated.Findings: The mean age of the prepubertal children was 9, 20 ±1, 8. Hepatosteatosis was detected with B-Mode USG in 50(%51, 5) prepubertal obese children andhepatosteatosis was detected with Dopler USG in 30(%30, 9) prepubertal obese children .In prepubertal group, weight, weightSDS, BMI, waist circumference, alanine transferase, aspartat transaminase and trigliseride levels were significantly higher in hepatosteatosis group detected with B-Mode.When obese prepubertal patients were grouped according to insülin resistance and HDL-C level, there were no significant difference between groups in two types of radiologic method. ALT, AST, fasting insülin , HOMA-IR, waist circumference was correlated with fatty liver detected with B-Mode USG . Only alt level was correlated with fatty liver with Dopler USG.The mean age of the adolescent children were 12, 90±1, 75. Hepatosteatosis was detected with B-Mode USG in 75 (%65, 78) obese children andhepatosteatosis was detected with Dopler USG in 43(%37, 71) pubertal obese children .In pubertal group, ALT, AST, HDL, HOMA-IR, weight, weight SDS , BMI, BMI SDS, waist circumference, hip circumference were significantly higher in hepatosteatosis group detected with B-Mode. ALT, AST, fasting insülinve HOMA-IR were higher in fatty liver group detected by doplerUSG.When obese pubertal patients were grouped according to insülin resistance and HDL-C level, there were no significant difference in two types of radiologic method. ALT, fasting insülin , HOMA-IR, waist and hip circumference, BMI, BMI SDS, weight and Weight SDS was correlated with fatty liver detected with B-Mode USG .Conclusion: Fatty liver can be detected both pubertal and prepubertal obese children. Although biopsy is required for definitive diagnosis, USG is simple and non-invasive method that can detect hepatosteosis. Conventional B-Mode USG and Doppler USG can be used to detect hepatosteatosis. Hepatosteatosis can be detected in high frequency in pubertal and prepubertal obese children by B-Mod USG when compared with Doppler USG. But this doesn?t show us that B-Mod USG is more sensitive than Doppler USG to detect hepatosteatosis.