Comparative efficacy of different treatment modalities in the management of pediatric non-alcoholic fatty liver disease: A systematic review and network meta-analysis

Theodoridis, Xenophon; Vadarlis, Andreas; Bakaloudi, Dimitra Rafailia; Gkiourtzis, Νikolaos; Dionysopoulos, Georgios; Karanika, Evangelia; Tsekitsidi, Eirini; Chourdakis, M.

doi:10.1016/j.pharmthera.2022.108294

Cited by 8 publications

(6 citation statements)

References 49 publications

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“…A meta-analysis confirmed that vitamin E treatment significantly reduces ALT, AST and body mass index (BMI) in NAFLD patients, but it did not decrease the fibrosis score and total cholesterol [ 131 ]. Similar results were obtained in a meta-analysis of studies with pediatric NAFLD patients [ 132 ].…”

Section: Oxidative Stress In Fatty Liver Diseasesupporting

confidence: 88%

Oxidative Stress in Liver Pathophysiology and Disease

Allameh,

Niayesh-Mehr,

Aliarab

et al. 2023

Antioxidants

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The liver is an organ that is particularly exposed to reactive oxygen species (ROS), which not only arise during metabolic functions but also during the biotransformation of xenobiotics. The disruption of redox balance causes oxidative stress, which affects liver function, modulates inflammatory pathways and contributes to disease. Thus, oxidative stress is implicated in acute liver injury and in the pathogenesis of prevalent infectious or metabolic chronic liver diseases such as viral hepatitis B or C, alcoholic fatty liver disease, non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). Moreover, oxidative stress plays a crucial role in liver disease progression to liver fibrosis, cirrhosis and hepatocellular carcinoma (HCC). Herein, we provide an overview on the effects of oxidative stress on liver pathophysiology and the mechanisms by which oxidative stress promotes liver disease.

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Section: Oxidative Stress In Fatty Liver Diseasesupporting

confidence: 88%

Oxidative Stress in Liver Pathophysiology and Disease

Allameh,

Niayesh-Mehr,

Aliarab

et al. 2023

Antioxidants

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“…In this study, we compared the efficacy of seven currently available clinically applied anti-diabetic treatments by combining literature searches to find 18 studies which met the inclusion criteria. Consistent with most previous similar studies, the outcomes of interest that we compared are improvements in two biochemical markers, including ALT and AST, in patients with non-diabetic NAFLD ( Theodoridis et al, 2022 ). Studies on ALT and AST, with 1,141 and 908 patients enrolled, respectively, represent a large sample size.…”

Section: Discussionsupporting

confidence: 64%

“…All variables are continuous and given as means with standard deviation (SD) in studies where anti-diabetic medications constitute the intervention ( Huang et al, 2021 ; Theodoridis et al, 2022 ). The study will report continuous variables as mean difference (MD = absolute difference between the means of two groups, defined as the difference in means between the treatment and control groups and calculated with the same scale) or standardized mean difference (SMD = mean difference in outcome between groups/standard deviation of outcome between subjects, used to combine data when trials with different scales), with 95% confidence intervals (CI) and analysis.…”

Section: Methodsmentioning

confidence: 99%

Comparison of efficacy of anti-diabetics on non-diabetic NAFLD: A network meta-analysis

Jin

Cui²,

Jin³

et al. 2023

Front. Pharmacol.

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Objective: This study aimed to assess the efficacy of currently used anti-diabetic medications in the treatment of non-alcoholic fatty liver disease (NAFLD) without diabetes. DESIGN: The efficacy of various anti-diabetic medicines on non-alcoholic fatty liver disease in the absence of diabetes was evaluated by searching Pubmed, Embase, Cochrane Library, and Web of Science for randomized controlled trials (RCT) only. The methodological quality was evaluated using the Revised Cochrane risk-of-bias tool for randomized trials (RoB2), and the data were analyzed using Stata software (version 15.1). Results: All papers published between the time of the pooling and September 2022 were searched. There were a total of 18 randomized controlled studies with a total sample size of 1141 cases. The outcomes of interest included variations in alanine transaminase (ALT) and aspartate transaminase (AST). Rosiglitazone (SUCRA: 100%) and vildagliptin (SUCRA: 99.9%) were the best anti-diabetic medicines to improve ALT and AST, respectively, in patients with NAFLD without diabetes, according to the findings of this network meta-analysis. Conclusion: In accordance with the Network Ranking plot, Rosiglitazone was the best anti-diabetic medicine for improving ALT, and vildagliptin was the best for improving AST in patients with non-diabetic NAFLD.

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“…In addition, the use of vitamin E, vitamin D, omega-3, and probiotics represents a good option to counteract NAFLD, blocking the development of fibrosis and the progression of liver disease [110,157]. Indeed, these molecules induce significant improvements in metabolic parameters such as a reduction in oxidative stress, insulin resistance, visceral and liver fat, and transaminases levels [110].…”

Section: Discussionmentioning

confidence: 99%

Nutritional Approaches in Children with Overweight or Obesity and Hepatic Steatosis

et al. 2023

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Childhood obesity is a global public health problem. Worldwide, 41 million children under 5 years and 340 million children and adolescents between 5 and 19 years are overweight. In addition, the recent COVID-19 epidemic has further amplified this social phenomenon. Obesity is a condition associated with various comorbidities, such as nonalcoholic fatty liver disease (NAFLD). The pathophysiology of NAFLD in obesity is intricate and involves the interaction and dysregulation of several mechanisms, such as insulin resistance, cytokine signaling, and alteration of the gut microbiota. NAFLD is defined as the presence of hepatic steatosis in more than 5% of hepatocytes, evaluated by histological analysis. It can evolve from hepatic steatosis to steatohepatitis, fibrosis, cirrhosis, hepatocellular carcinoma, and end-stage liver failure. Body weight reduction through lifestyle modification remains the first-line intervention for the management of pediatric NAFLD. Indeed, studies suggest that diets low in fat and sugar and conversely rich in dietary fibers promote the improvement of metabolic parameters. This review aims to evaluate the existing relationship between obesity and NAFLD in the pediatric population and to assess the dietary patterns and nutritional supplementations that can be recommended to prevent and manage obesity and its comorbidities.

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Comparative efficacy of different treatment modalities in the management of pediatric non-alcoholic fatty liver disease: A systematic review and network meta-analysis

Cited by 8 publications

References 49 publications

Oxidative Stress in Liver Pathophysiology and Disease

Oxidative Stress in Liver Pathophysiology and Disease

Comparison of efficacy of anti-diabetics on non-diabetic NAFLD: A network meta-analysis

Nutritional Approaches in Children with Overweight or Obesity and Hepatic Steatosis

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