الفهرس 
Childhood ObesityOnly 14 pages are availabe for public view
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Abstract
There is a dramatic rise in the prevalence of obesity among Egyptian children that has reached alarming levels. Fructose consumption has more than doubled in the last three decades. Excessive fructose consumption has been linked in some studies to the development and severity of NAFLD.
So the purpose of this study was to assess dietary fructose intake in obese children and adolescents and assess its possible relation to NAFLD and its progression to fibrosis. Measurement of serum P3NP levels, as a marker of hepatic fibrosis, was done to explore its relation to the occurrence and degree of NAFLD.
This study is a cross-sectional case-control study that included 55 obese children and adolescents recruited from the Pediatric Obesity Clinic. Also 30 healthy age and sex matched children and adolescents were included as a control group.
These individuals were subjected to
Ӏ. Full history taking: including age, sex & therapeutic history.
Π. Full clinical examination include
• Systemic examination to exclude other illnesses.
• Anthropometric and auxologic measurements Including weight & it’s SDS, height & it’s SDS, BMI & it’s SDS, waist circumference & it’s SDS, hip circumference & it’s SDS, waist/ hip ratio& it’s SDS.
• Tanner pubertal staging
• Blood pressure measurement
Ш. Assessment of dietary fructose by the food frequency questionnaire (FFQ)
ӀѴ. Laboratory investigations included measurement of uric acid, ALT, fasting lipid profile, fasting blood sugar, fasting insulin level, P3NP and calculation of HOMA.
Ѵ. Abdominal ultrasonography.
Our study revealed the following:
1. Weight, height, BMI, WC, hip circumference, waist/hip circumference and their SDS were significantly higher in patients.
2. TC, TG, FBS, fasting insulin, HOMA, S.uric acid, ALT were significantly higher in patients than controls except HDL-C, LDL-C which show no significant difference between both.
3. The patients had significantly higher P3NP level than controls.
4. The mean systolic and diastolic BPs were significantly higher in patients than controls.
5. The patients had significantly higher frequencies of pre-hypertension and stage1 hypertension than controls.
6. There were significant positive correlations between the BMI and each of the fasting insulin and HOMA.
7. There was a significant positive correlation between s. uric acid and BMI and a significant negative correlation between s. uric acid and fasting blood sugar.
8. The patients had significantly higher consumption of fructose from natural sources like fruits and vegetables, higher total fructose content of food measured in grams per year from both natural and processed sources and higher total calories.
9. The patients had significantly higher percentage of grade 1 and 2 NAFLD in contrast to controls who had normal liver by ultrasound.
10. There was a significant correlation between the consumption of fructose obtained from processed sources and the development of systolic pre hypertension and hypertension.
11. There were non significant correlations between the consumption of fructose obtained from processed sources, natural sources, total fructose and grading of fatty liver, dyslipidemia, insulin resistance, diastolic pre hypertension or hypertension.
12. There were significant negative correlations between P3NP which served as a marker of liver fibrosis and each of fructose obtained from processed sources, total fructose and total calories.
13. There was a significant regression analysis between the BMI and each of the fasting insulin and s. uric acid.
14. There were significant regression analysis between s. uric acid and fasting blood sugar, G/I ratio, BMI and age.