Avaliação morfoestrutural por ressonância magnética comparativa entre crianças com obesidade e obesidade grave

Abstract

Childhood obesity is a serious and growing public health problem in Brazil and in several countries around the world, due to its associated comorbidities. There has been a notable increase in the prevalence of severe obesity, with a higher risk of developing comorbidities in childhood and adolescence, as well as persistent obesity and its complications in adulthood. The increased incidence and prevalence of childhood obesity is associated with a concomitant increase in non-alcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease in children and adolescents, affecting between 5 and 15% of children and adolescents worldwide, and reaching 38% in obese children. The gold standard for diagnosing NAFLD and its severity is liver biopsy, which is invasive and limited by sampling bias and complications, making its widespread application unfeasible. Most patients are asymptomatic, with a minority presenting nonspecific symptoms such as abdominal discomfort and fatigue. Hepatomegaly is one of the most common clinical findings, but it is difficult to characterize in patients with marked abdominal adipose tissue. Magnetic resonance imaging (MRI) is a method that allows, in a single examination, the precise characterization of liver volume and other biomarker parameters, such as liver fat and iron quantification, and myosteatosis. This project aims to evaluate the morphostructural differences by MRI, using the free and open-source Horos software, and laboratory metabolic differences between children with obesity and severe obesity from patients at the Childhood Obesity Outpatient Clinic of the Pedro Ernesto University Hospital (HUPE-UERJ). A significant difference in liver volume and amount of muscle fat was demonstrated by MRI, as well as higher TSH levels, in the group of children with severe obesity, as well as a significantly younger age in this group, highlighting the importance of including auxiliary indicators in the early detection of metabolic complications associated with childhood obesity.