Approach to prevention and treatment of non-alcoholic fatty liver disease in children with obesity from the position of current international recommendations

Background. The article deals with the problem of preventing the development and treatment of non-alcoholic fatty liver disease (NAFLD) in children with obesity of the alimentary-constitutional type. The purpose of the work was to study the efficacy and safety of omega-3 polyunsaturated fatty acids (PUFAs) with vitamin E and a multiprobiotic complex enriched with vitamins for the prevention the development and progression of steatohepatosis. Materials and methods. In total, 55 children diagnosed with alimentary-constitutional obesity were followed-up. All patients were prescribed drug the­rapy with omega-3 PUFA Reytoil and the combined probiotic Breveluck (Lactobacillus helveticus R0052, Lactococcus lactis ssp. lactis R1058, Bifidobacterium longum R0175, Lactobacillus rhamnosus R0011, Bifidobacterium breve R0070, Streptococcus thermophilus R0083, Bifidobacterium bifidum R0071, Lactobacillus casei R0215, Lactobacillus plantarum R1012) against the background of lifestyle modification. Results. The course of NAFLD in most children had no characteristic clinical symptoms and severe cytolysis syndrome. Structural and functional changes in the liver with NAFLD can cause metabolic disorders with the formation of severe atherogenic dyslipidemia. A three-month treatment of NAFLD with omega-3 PUFA Reytoil and combined probiotic Breveluck showed a significant decrease in the activity of hepatic cytolytic enzymes and an improvement in the blood lipid spectrum. Conclusions. The prescription of omega-3 PUFAs in combination with strains of probiotic cultures with proven clinical efficacy in NAFLD on the background of lifestyle modification contributes to the effective prevention and treatment of this pathology in children.