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Artículo

Strategic interventions in clinical randomized trials for metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity in the pediatric population: a systematic review with meta-analysis and bibliometric analysis

Resumen

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is a prevalent hepatic condition linked to metabolic alterations. It gradually causes liver damage and potentially progresses to cirrhosis. Despite its significance, research, especially in the pediatric population, is limited, leading to contradictory findings in diagnosis and treatment. This meta-analysis aims to synthesize existing literature on therapeutic interventions for MASLD in children and adolescents. Methods: A comprehensive search of randomized controlled clinical trials yielded 634 entries from PubMed, Scopus, and Web of Science up to 2023. Interventions included medications, behavioral modifications, dietary changes, probiotics, supplements, surgical procedures, or combinations. The analysis focused on studies with treatment duration of at least 3 months, employing a random-effects REML meta-analysis model. Treatment effects on anthropometric measurements and biochemical components were examined and adjusted for heterogeneity factors analysis. A bibliometric analysis for insights into research contributors was performed. Results: The systematic review incorporated 31 clinical trials, with 24 meeting criteria for meta-analysis. These comprised 3 medication studies, 20 with supplements, 4 focusing on lifestyle, and 4 centered on diets. Significant overall treatment effects were observed for ALT, AST, BMI, and HOMA-IR mainly by supplements and lifestyle. Meta-regression identified age, BMI changes, and treatment duration as factors modifying ALT concentrations. Bibliometric analysis involving 31 linked studies highlighted contributions from 13 countries, with the USA, Spain, and Chile being the most influential. Conclusions: We conclude that supplementation and lifestyle changes can effectively impact ALT and AST levels, which can help address liver issues in obese children. However, the evaluation of risk bias, the high heterogeneity, and the bibliometric analysis emphasize the need for more high-quality studies and broader inclusion of diverse child populations to provide better therapeutic recommendations. Trial registration: PROSPERO, CRD42023393952. Registered on January 25, 2023.
Omaña-Guzmán, Isabel (57255167000); Rosas-Diaz, Marisol (37034946100); Martínez-López, Yoscelina Estrella (57213173217); Perez-Navarro, L. Monserrat (44961377300); Diaz-Badillo, Alvaro (10043843600); Alanis, Anthony (58615666500); Bustamante, Alejandra (58565468900); Castillo-Ruiz, Octelina (56002748400); del Toro-Cisneros, Noemi (58027760500); Esquivel-Hernandez, Diego Armando (57189068118); Garcia-Villalobos, Gloria (57203245283); Garibay-Nieto, Nayely (35172816300); Garcia-Oropesa, Esperanza Milagros (57203790328); Hernandez-Martinez, Juan Carlos (59418607700); Lopez-Sosa, Elena Beatriz (57221806875); Maldonado, Carlos (59418480700); Martinez, David (59418607800); Membreno, Joshua (59418480800); Moctezuma-Chavez, Oscar Omar (57221806126); Munguia-Cisneros, Claudia X. (58565468800); Nava-González, Edna J. (26221448200); Perales-Torres, Adriana L. (57189711290); Pérez-García, Adolfo (57194031960); Rivera-Marrero, Hector (59418480900); Valdez, Alisha (59417967300); Vázquez-Chávez, Alfonso Alejandro (59418733100); Ramirez-Pfeiffer, Carlos (12143457800); Carter, Kathleen V. (57224823597); Tapia, Beatriz (57221256903); Vela, Leonel (58707018300); Lopez-Alvarenga, Juan Carlos (6602741811)
Strategic interventions in clinical randomized trials for metabolic dysfunction-associated steatotic liver disease (MASLD) and obesity in the pediatric population: a systematic review with meta-analysis and bibliometric analysis
2024
10.1186/s12916-024-03744-x
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85209742557&doi=10.1186%2fs12916-024-03744-x&partnerID=40&md5=0473819c6d8f2b3b4e0114498d1caac7
Pediatric Obesity Clinic and Wellness Unit, Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico; Laboratorio de Biologia Molecular, Universidad Autónoma de Tamaulipas, Tamaulipas, Mexico; UT Health Science Center at Houston’s School of Public Health, Brownsville, TX, United States; Servicio de Nefrologia. Hospital General de México Dr. Eduardo Liceaga, Mexico City, Mexico; Department of Health and Behavioral Sciences, Texas A & amp;M University, San Antonio, TX, United States; School of Medicine, The University of Texas Rio Grande Valley, Edinburg, TX, United States; Medicina Interna, Hospital Angeles Clinica Londres, Mexico City, Mexico; Universidad Autónoma de Tamaulipas, Tamaulipas, Mexico; Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de La Nutricion Salvador Zubiran, Mexico City, Mexico; Departamento de Procesos y Tecnología, Universidad Autónoma Metropolitana Cuajimalpa, Mexico City, Mexico; Angiologia y Cirugía Vascular, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado de México (ISSTE), Hospital 20 de Noviembre, Mexico City, Mexico; Instituto Nacional de Enfermedaes Respiratorias, Mexico City, Mexico; Department of Biology, The University of Texas Rio Grande Valley, Edinburg, TX, United States; Asociación Odontológica Mexicana Para La Enseñanza y La Investigación, Mexico City, Mexico; Centro Especializado de Metabolismo y Diabetes (CEDIAMET), Universidad México Americana del Norte, Tamaulipas, Mexico; Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León, Monterrey, Mexico; Research Department, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico; Universidad del Valle de México, Campus Hermosillo, Sonora, Mexico; Escuela de Medicina, Universidad México Americana del Norte, Tamaulipas, Reynosa, Mexico; Faculty Affairs, Asst Dean Faculty Development, The University of Texas Rio Grande Valley, Edinburg, TX, United States; Division of Population Health & amp; Biostatistics, School of Medicine, University of Texas Rio Grande Valley, 2102 Treasure Hills Boulevard, Edinburg, 78550, TX, United States
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