Nonalcoholic Fatty Liver Disease in Italian Children with Down Syndrome: Prevalence and Correlation with Obesity-Related Features

Abstract

We demonstrated that, independently from the obese phenotype, children with DS display a greater risk to develop NAFLD than the general pediatric population.

Gastrointestinal disorders in Down syndrome

“…It was detected in adolescents or young adults. Valentini et al () related that the severity of liver brightness on ultrasound scan correlated positively with body mass index, triglycerides, low‐density lipoprotein‐cholesterol, and leptin levels and negatively with adiponectin. They demonstrated that, independently from the obese phenotype, children and adolescents with DS display a greater risk to develop nonalcoholic fatty liver disease than the general pediatric population (Valentini et al, ).…”

“…Valentini et al () related that the severity of liver brightness on ultrasound scan correlated positively with body mass index, triglycerides, low‐density lipoprotein‐cholesterol, and leptin levels and negatively with adiponectin. They demonstrated that, independently from the obese phenotype, children and adolescents with DS display a greater risk to develop nonalcoholic fatty liver disease than the general pediatric population (Valentini et al, ). An elevated incidence of hepatic steatosis detected by histological evaluation in patients with DS (63%), twice as high as that seen in other intellectually deficient controls had already been reported in the first half of the last century (De Matteo & Vajro, ).…”

Down Syndrome and Pediatric Nonalcoholic Fatty Liver Disease: A Causal or Casual Relationship?

“…Valentini et al, reporting on 280 children and teenagers with Down syndrome, contribute to the discussion in this volume of The Journal. 11 The authors established a greater risk of ultrasonographically determined nonalcoholic fatty liver disease (NAFLD) in 84 patients with Down syndrome who had no known cause (other than excess weight) of systemic and liver disease leading to steatosis compared with the general pediatric population.…”

“…It is known that in the general population there is evidence of NAFLD in only 5%-8% of lean subjects, 22 a figure 10 times lower than that reported by Valentini et al for their subjects with Down syndrome. 11 Lean NAFLD typically represents a patient subpopulation with normal BMI and hepatic steatosis identified on imaging. 23 Visceral (or waist circumference or central) obesity, rather than overall (BMI-defined) obesity and genetic risk factors (eg, patatin-like phospholipase domain-containing protein 3/adiponutrin [PNPLA3]), is associated with nonobese NAFLD.…”

Pediatric Fatty Liver and Obesity: Not Always Just a Matter of Non-Alcoholic Fatty Liver Disease

“…Non-alcoholic fatty liver disease is a frequent comorbidity of Down syndrome, probably due to poor physical activity [24,25]. In these patients, obesity and obstructive sleep apnea syndrome-related nocturnal hypoxia, by inducing oxidative stress in the liver, may represent additional risk factors triggering NAFLD and its progression to more severe forms [26,27].…”