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Pulmonary function test abnormalities in children and adolescents with non-alcoholic fatty liver disease

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Abstract

Association between pulmonary function tests (PFTs) and non-alcoholic fatty liver disease (NAFLD) has been reported in adult studies; however, there is lack of pediatric studies. Our study aimed to evaluate PFTs in children with NAFLD. A total of 137 children with NAFLD and 100 healthy children of matched age and sex were included in the study. Different PFTs including forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, residual volume (RV), and total lung capacity (TLC) were performed for all included children. Lipid profile, insulin resistance, fasting and postprandial glucose level, and high sensitive C reactive protein (hs-CRP) were measured. FEV1 %, FVC %, FEV1/FVC ratio, RV, and TLC were significantly lower in the patient group compared with the control group (P < 0.05), while RV and hs-CRP were significantly higher in children with NAFLD. Restrictive lung dysfunction was the commonest pulmonary dysfunction detected in children with NAFLD (21.9%). PFT indices were significantly correlated with grade and duration of NAFLD, insulin resistance, waist circumference, and hs-CRP. Regression analysis revealed that insulin resistance and hs-CRP were independently associated with decreased PFT indices.

Conclusion: PFT indices were impaired in children with NAFLD and this impairment was independently associated with insulin resistance and hs-CRP.

What is Known:

• Pulmonary function tests (PFTs) abnormalities are common in adults with nonalcoholic fatty liver disease (NAFLD).

• Studies involving PFTs abnormalities in pediatric NAFLD are lacking.

What is New:

• It is the first study that assessed PFT in pediatric patients with NAFLD.

• PFTs abnormalities are present in children with NAFLD.

• Insulin resistance and high sensitive C reactive protein are independently associated with the decline of PFTs in children with NAFLD.

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Author information

Authors and Affiliations

  1. Pediatric Department, Faculty of Medicine, Tanta University, El motasem street No 6, Tanta, Egypt

    Doaa El Amrousy & Samir Hasan

  2. Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt

    Heba El Ashry

  3. Theodor Bilharz Research Institute, Cairo, Egypt

    Sara Maher

  4. Chest Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt

    Salwa Ganna

Authors
  1. Doaa El Amrousy
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  2. Heba El Ashry
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  3. Sara Maher
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  4. Salwa Ganna
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  5. Samir Hasan
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Contributions

D.E., S.G., and S.H. collected the study data, wrote, revised, and approved the manuscript. H.E. and S.M. performed the statistical analysis, collected the study data, wrote, revised, and approved the manuscript.

Corresponding author

Correspondence to Doaa El Amrousy.

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Ethical approval

Local ethics committee of Faculty of Medicine, Tanta University, approved the study. The study is in accordance with the ethical standards of institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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An informed consent was obtained from the parents of all subjects of the study before enrollment.

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All the authors transfer, assign, or otherwise convey all copyright ownership, including any and all rights exclusively to the journal, in the event that such work is published by the journal.

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The authors declare that they have no conflict of interest.

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Communicated by Peter de Winter

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El Amrousy, D., El Ashry, H., Maher, S. et al. Pulmonary function test abnormalities in children and adolescents with non-alcoholic fatty liver disease. Eur J Pediatr 180, 1693–1699 (2021). https://doi.org/10.1007/s00431-021-03941-3

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  • DOI: https://doi.org/10.1007/s00431-021-03941-3

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