Metabolic Complications and Ultrasound-Detected Liver Abnormalities in Paediatric Patients With Duchenne Muscular Dystrophy.

BACKGROUND

Nutritional care in Duchenne muscular dystrophy (DMD), a progressive neuromuscular disorder, is particularly important due to the high risk of obesity in childhood and malnutrition in adolescence.

OBJECTIVES

The study aimed to evaluate metabolic complications in DMD, such as liver USS (ultrasound scan) abnormalities and abnormal biochemical markers in relation to disease progression.

METHODS

All patients underwent physical examination, laboratory tests and abdominal USS with liver size and echogenicity assessment with subsequent comparison within age subgroups.

RESULTS

The mean age of the 131 participants was 11.2 ± 4.4 years; 72 were ambulant. Most (78%) were treated with steroid therapy for an average of 52.6 ± 46.7 months. Increased BMI z-scores were noted in 41% of boys with DMD (19% obese, 22% overweight), with significant age-related variation (χ2 = 15.68, p = 0.0035). USS revealed hepatomegaly in 56% and steatosis in 24% of patients; both were more frequent with age and higher BMI z-score. Boys over 13 years, with normal liver scan, had lower weight/BMI z-scores, CRP level and higher HDL-C levels. Dyslipidemia was reported in 81% of patients, and insulin resistance in 13.9%, with insulin levels increasing with age.

CONCLUSIONS

Metabolic complexity in DMD calls for early targeted care; understanding the dystrophin role may be crucial.