Effects of obesity reduction on transient elastography–based parameters in pediatric non-alcoholic fatty liver disease

Isoura, Yoshiharu; Cho, Yuki; Fujimoto, Hiroki; Hamazaki, Takashi; Tokuhara, Daisuke

doi:10.1016/j.orcp.2020.08.005

Cited by 12 publications

(7 citation statements)

References 35 publications

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“…Another limitation is the detection of hepatic steatosis using the cut-off value of CAP (275 dB/m) reported by the recent EASL guidelines [ 22 ]. Indeed, this cut-off is not consensual since it may vary greatly according to the population involved (pediatric [ 44 , 45 ] or adult [ 46 – 48 ]) and depending on the desired objective (to maximize the sum of sensitivity and specificity, achieve greater accuracy, etc.). Recent data demonstrated that simple steatosis is not prognostically as benign as previously thought [ 49 , 50 ] and, consequently, early detection of NAFLD using reliable non-invasive and widely available techniques will be a relevant task in the future.…”

Section: Discussionmentioning

confidence: 99%

Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study

Thévenot

Vendeville²,

Weil³

et al. 2022

PLoS ONE

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Although coronary artery disease (CAD) and advanced liver fibrosis (AdLF) are commonly associated in patients with non-alcoholic fatty liver disease (NAFLD), the prevalence of AdLF and the diagnostic performance of non-invasive fibrosis tests (NITs) in CAD patients remains unknown. We aimed to prospectively screen for AdLF in patients with documented CAD using NITs and Fibroscan. High and intermediate zones of NITs were combined to define AdLF. AdLF was suspected whenever APRI ≥ 0.5, Forns index ≥ 4.2, NAFLD fibrosis score (NFS) ≥ -1.455/0.12 for age </≥ 65 yrs), Fib4 (≥ 1.30/2.0 for age </≥ 65 yrs) and eLIFT≥ 8. A presumed AdLF assessed by Fibroscan ≥ 8 kPa was the primary outcome measure. Results were given on the basis of intent-to-diagnose liver stiffness ≥ 8 kPa. Among 189 patients (age 60±7years), 10 (5.3%) had a Fibroscan ≥ 8 kPa, of whom 5 underwent liver biopsy (F3/F4: n = 3; no fibrosis: n = 2). AdLF was suspected in 31% of cases using eLIFT (specificity, Sp 70%), 85% with Forns (Sp 16%), 38% with NFS (Sp 63%), 25% with Fib4 (Sp 74%), and 10% with APRI (Sp 91%). In 149 patients “at-risk” of NAFLD (i.e., elevated ALT or diabetes or hypertriglyceridemia or BMI ≥25 kg/m2), AdLF ranged between 10% (APRI) to 84% (Forns). In this subgroup, the most efficient NITs to predict Fibroscan ≥ 8 kPa were eLIFT (Se 60%, Sp 70%) and NFS (Se 70%, Sp 60%). Finally, in CAD patients with risk factors for NAFLD, NFS or the more user-friendly eLIFT are the most attractive first-line biochemical NITs to discriminate good candidates for Fibroscan.

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Section: Discussionmentioning

confidence: 99%

Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study

Thévenot

Vendeville²,

Weil³

et al. 2022

PLoS ONE

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“…A prospective study of a dietary intervention in patients with biopsy-confirmed NASH indicated that a 10% decrease in body weight has histological benefits [ 40 ]. In addition, weight reduction ameliorated both hepatic fat deposition and liver stiffness associated with NAFLD in obese children [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Subclinical steatohepatitis and advanced liver fibrosis in health examinees with nonalcoholic fatty liver disease (NAFLD) in 10 South Korean cities: A retrospective cross-sectional study

et al. 2021

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Background Nonalcoholic steatohepatitis (NASH) has a risk of progressing to cirrhosis. The prevalence of NASH and its associated risk factors in community populations are relatively unknown. This study aimed to determine the prevalence of NASH and advanced liver fibrosis using magnetic resonance elastography (MRE), and determine those risk factors in health examinees with asymptomatic fatty liver. Methods This study consecutively selected subjects who underwent health checkups at 13 health-promotion centers in 10 Korean cities between 2018 and 2020. Hepatic steatosis and stiffness were assessed using ultrasonography and MRE, respectively. Stages of liver stiffness were estimated using MRE with cutoff values for NASH and advanced liver fibrosis of 2.91 and 3.60 kPa, respectively. Results The overall prevalence of NASH and advanced liver fibrosis in the subjects with fatty liver were 8.35% and 2.04%, respectively. Multivariate logistic regression analysis indicated that central obesity (OR = 5.12, 95% CI = 2.70–9.71), increased triglyceride (OR = 3.29, 95% CI = 1.72–6.29), abnormal liver function test (OR = 3.09, 95% CI = 1.66–5.76) (all P<0.001), and decreased high-density lipoprotein cholesterol (OR = 5.18, 95% CI = 1.78–15.05) (P = 0.003) were associated with NASH. The main risk factor for advanced liver fibrosis was diabetes (OR = 4.46, 95% CI = 1.14–17.48) (P = 0.032). Conclusion NASH or advanced liver fibrosis is found in one-tenth of health examinees with asymptomatic fatty liver. This suggests that early detection of NASH should be considered to allow early interventions such as lifestyle changes to prevent the adverse effects of NASH and its progression in health examinees with asymptomatic fatty liver.

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“…Lifestyle intervention is considered the first line, as it has no side effects and confers multiple cardiometabolic benefits [ 6 , 107 , 140 ]. Diet- and exercise-intervention-based reduction of body weight has been shown to be effective in reducing hepatic fat deposition in children and adolescents with obesity and NAFLD [ 141 ].…”

Section: The Effects Of Physical Exercise On Nafldmentioning

confidence: 99%

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

et al. 2022

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Non-alcoholic fatty liver disease (NAFLD) is an important health concern during childhood; indeed, it is the most frequent cause of chronic liver diseases in obese children. No valid pharmacological therapies for children affected by this condition are available, and the recommended treatment is lifestyle modification, usually including nutrition and exercise interventions. In this narrative review, we summarized up-to-date information on the benefits of physical exercise on NAFLD in children and adolescents with obesity. The role of exercise as non-pharmacological treatment was emphasized in order to provide recent advances on this topic for clinicians not deeply involved in the field. Several studies on obese children and adults confirm the positive role of physical activity (PA) in the treatment of NAFLD, but to date, there are no pediatric randomized clinical trials on exercise versus usual care. Among the pathogenic mechanisms involved in the PA effects on NAFLD, the main players seem to be insulin resistance and related inflammation, oxidative stress, and gut dysbiosis, but further evaluations are necessary to deeply understand whether these factors are correlated and how they synergistically act. Thus, a deeper research on this theme is needed, and it would be extremely interesting.

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Effects of obesity reduction on transient elastography–based parameters in pediatric non-alcoholic fatty liver disease

Cited by 12 publications

References 35 publications

Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study

Systematic screening for advanced liver fibrosis in patients with coronary artery disease: The CORONASH study

Subclinical steatohepatitis and advanced liver fibrosis in health examinees with nonalcoholic fatty liver disease (NAFLD) in 10 South Korean cities: A retrospective cross-sectional study

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

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