“Comorbid” is a word that seems to have started out with a stricter meaning, describing a disease process unrelated to the patient’s primary diagnosis. But over time, our understanding of the body and mind have increased. How can anything, really, be independent of something else going on in the same organism, at the same time? Recently, the tendency has been to think of a comorbidity as a condition with a relationship to the presenting problem, of either cause or effect. Or a comorbidity might be another effect of the same cause.
This is how it works in childhood obesity. Research has found innumerable links, clues, hints, and connections. There are plenty of red flags, and not enough road crews to patch all the potholes — plenty of leads, and not enough resources to follow them all. But sometimes, the connection between concomitant pathologies is unmistakable and clear as day. Yesterday we were talking about fatty liver disease, and there is more to say.
Interpreting a research paper published in the March issue of the journal Hepatology, Karen N. Peart writes:
Obese youths with particular genetic variants may be more prone to fatty liver disease… Experts say nonalcoholic fatty liver disease is now the leading cause of chronic liver disease in children and adolescents in industrialized countries.
Lead author of this study, conducted at Yale, is Dr. Nicola Santoro, of the Department of Pediatrics. With MRI technology, the team measured the liver fat of children whose average age was 13. Approximating the population of the United States, the study included Caucasians, African-Americans, and Hispanics.
The researchers write:
We observed that a common genetic variant known as Patatin-like phospholipase domain containing protein-3 (PNPLA3) working with a regulatory protein called glucokinase (GCKR), was associated with increased triglycerides, very low-density lipoproteins levels, and fatty liver… Our findings confirm that obese youths with genetic variants in the GCKR and PNPLA3 genes may be more susceptible to fatty liver disease.
Reports from Britain suggest that thing are no better there. Two young children, ages 6 and 8, made headlines there by having strokes, probably caused by the physiological stress of carrying too much weight. Thousands of children desperately need intervention. All over the kingdom, kids are turning up with illnesses that doctors are more used to seeing in middle-aged patients. And the ones who seek treatment are only the tip of the iceberg.
Such is the belief of Dr. Ken Ong, of Addenbrooke’s Hospital in Cambridge, who says:
The one and two year-olds we see are massively obese but it is only the very extreme who are coming to hospital clinics. There will be many more who are in the community or are not being recognized at all.
Aside from a disfiguring birth defect, few sights can dismay a pediatrician as much as a one-year-old baby who weighs twice as much as a normal child of that age is supposed to weigh. Yet they are turning up all over the place, and parents are catching the blame, for taking their infants off the breast or bottle too soon, and especially, for introducing junk food into the diets of defenseless babies.
Your responses and feedback are welcome!
Source: “Researchers unravel genetic mechanism of fatty liver disease in obese children,” HealthCanal.com, 03/27/12
Source: “Struck by a stroke at age SIX: Obesity epidemic fuelled by parents feeding children pureed junk food,” DailyMail.co.uk, 06/13/11
Image by lovelihood (Kim Love), used under its Creative Commons license.