Background:
besity is a risk factor for gallstone development in children and adolescents. However, the exact risk factors that determine which obese paediatric patients develop gallstones have not been identified yet. Particularly, no data are available on the risks related to lifestyle interventions in these patients.
Design::
In this prospective cohort study 407 children and adolescents (age 8-18 years) with severe obesity (SDS-BMI >2.3 with comorbidity or SDS-BMI >3.0) participated in a lifestyle intervention programme during six months. Abdominal ultrasonography for the presence of gallstones, anthropometric measurements and biochemistry were evaluated before start and at the end of the lifestyle intervention.
Results:
14 out of 388 children (3.7%) had gallstones before lifestyle intervention. Those children with gallstones were more severely obese (P = 0.029*), with higher obesity related parameters. A history of two or more weight loss attempts seemed to increase the risk compared to less weight loss attempts.
During lifestyle intervention 17 children developed gallstones (5.9%). The degree of weight loss and improvement in its related anthropometric parameters all correlated with the risk of developing gallstones. Gallstones were only observed in those losing more than 10% of initial body weight and the risk increased sharply when losing more than 25% of initial weight. In multivariate analysis only weight loss was independently correlated. 29 (93%) children with gallstones remained asymptomatic and in 8 (25%) children gallstones dissolved during follow-up.
Conclusion:
The risk of gallstones in obese children and adolescents before and during life style intervention is mainly related to the degree of obesity and the degree of weight loss. Other factors did not correlate in this study. Complications of gallstones were rare.
