Nonalcoholic Fatty Liver Disease in Children

Seo, Jung Won

doi:10.5223/kjpgn.2011.14.3.209

Cited by 4 publications

(5 citation statements)

References 75 publications

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“…Dysregulated adipokine production caused by excess adipose tissue triggers chronic low-grade inflammation and enhances insulin resistance [724], an integral feature of metabolic syndrome. NAFLD has been regarded as the liver manifestation of metabolic syndrome [25]. Our data revealed an adjusted OR of 3.86 for the association between metabolic syndrome and suspected NAFLD in adolescents.…”

Section: Discussionmentioning

confidence: 52%

Association Between Vitamin D Deficiency and Suspected Nonalcoholic Fatty Liver Disease in an Adolescent Population

Cho

Kim

Shim

et al. 2019

Pediatr Gastroenterol Hepatol Nutr

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Purpose Vitamin D deficiency is a condition widespread throughout the world. Recent studies have suggested that vitamin D deficiency was associated with obesity and metabolic syndrome. The purpose of the study was to examine the relationship between vitamin D deficiency and nonalcoholic fatty liver disease (NAFLD) in adolescents. Methods The data were obtained from the Korean National Health and Nutrition Examination Survey from 2008–2014. A total of 3,878 adolescents were included in the study. Vitamin D deficiency was defined as a 25-hydroxyvitamin D concentration <20 ng/mL and suspected NAFLD was defined as an alanine transaminase concentration >30 U/L. Results Vitamin D deficiency was noted in 78.9% of the studied population. Age, body mass index, waist circumference, and blood pressure, glucose, cholesterol, and triglyceride levels were significantly higher in adolescents with suspected NAFLD than in adolescents without suspected NAFLD, while the mean vitamin D level was significantly lower in adolescents with suspected NAFLD. The multivariate-adjusted odds of suspected NAFLD were higher with increased age, male gender, obesity, and metabolic syndrome. Individuals with vitamin D deficiency were at higher risk of suspected NAFLD (odds ratio, 1.77; 95% confidence interval, 1.07–2.95) after adjusting for age, gender, obesity, and metabolic syndrome. Conclusion Vitamin D deficiency was associated with suspected NAFLD, independent of obesity and metabolic syndrome, in adolescents.

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Section: Discussionmentioning

confidence: 52%

Association Between Vitamin D Deficiency and Suspected Nonalcoholic Fatty Liver Disease in an Adolescent Population

Cho

Kim

Shim

et al. 2019

Pediatr Gastroenterol Hepatol Nutr

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“… 6 Additionally, NAFLD in children may be associated with significantly shorter survival than the general population because of liver failure or cirrhosis, especially in NASH patients. 7 To evaluate the severity of NASH, a liver biopsy is required, in which fibrosis is an important factor.…”

Section: Introductionmentioning

confidence: 99%

Pathologic Impact of Insulin Resistance and Sensitivity on the Severity of Liver Histopathology in Pediatric Non-Alcoholic Steatohepatitis

et al. 2017

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PurposeInsulin resistance (IR) has an important role in the development of non-alcoholic steatohepatitis (NASH). We aimed to analyze the association between liver histopathology and IR in pediatric patients with NASH.Materials and MethodsIn 24 children with non-alcoholic fatty liver disease (NAFLD), we investigated whether the hepatic pathologic characteristics have relations with following three biochemical indices; IR index including homeostasis model assessment of IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), and insulin sensitivity indices-free fatty acid (ISI-FFA).ResultsAmong 24 patients, 16 (66.6%) had a high NAFLD activity score (NAS), which is diagnostic of NASH. Higher serum triglyceride level was significantly correlated with a high NAS. Higher steatosis grades were significantly associated with low insulin sensitivity (p=0.023). In addition, severe lobular inflammation was associated with higher IR: HOMA-IR (p=0.014) and QUICKI (p=0.023). Severe fibrosis correlated with low insulin sensitivity and high IR indexes: ISI-FFA (p=0.049), HOMA-IR (p=0.028), and QUICKI (p=0.007).ConclusionPatients with high IR had more severe lobular inflammation and hepatic fibrosis. Analyses of biochemical and endocrine parameters can be applied to determine the severity of the hepatic pathologic status in patients with NASH, especially in children who cannot undergo a liver biopsy.

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“…Hepatic enzyme levels, such as ALT, AST, γ-GT, TG, and LDL, are known to be elevated in NAFLD patients [8], and ALT is used as a screening test especially in the diagnosis of pediatric NAFLD. However, in obese children, medical imaging tests can diagnose NAFLD even with normal hepatic enzyme levels [9].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Pharmacological Treatment in Pediatric Nonalcoholic Fatty Liver Disease

Cho

Kim

Paik

2012

Pediatr Gastroenterol Hepatol Nutr

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PurposeWith growing number of obese children, the prevalence of nonalcoholic fatty liver disease (NAFLD) in pediatric population is increasing. Nonalcoholic steatohepatitis (NASH) is a severe form of NAFLD, and can cause morbid complications. It is important to identify patients in order to grade pathologic severities and treat those children who possibly have NASH. This study was performed to evaluate whether the pharmacological therapy is also effective as well as the body weight reduction in pediatric NAFLD.MethodsAmong the 52 children presenting with obesity and hepatopathy, NAFLD was diagnosed through liver biopsy in 29 children, who were 7 to 14 years of age, from January 2006 to December 2011. The patients were advised to reduce their body weight through diverse methods. Medication with Ursodeoxycholic acid (UDCA) and vitamin E was performed in children whose liver functions did not improve or their weight reductions were not successful. The therapeutic effects were monitored and assessed via the biochemical profiles and the physical measurements.ResultsThe therapy of vitamin E and UDCA combined with body mass index (BMI) reduction showed significantly higher rate of improvement in clinical profiles, which could be seen in data of aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST/ALT ratio, alkaline phosphatase, total bilirubin and γ-glutamyl transpeptidase. Children whose BMI were successfully reduced showed favorable clinical improvements without any medication, but those without BMI reduction did not show any improvement despite medications.ConclusionThis study showed that the first line of therapy should be the BMI reduction in NAFLD and drug therapy combined with BMI reduction could have additive therapeutic effect in children with NAFLD.

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Nonalcoholic Fatty Liver Disease in Children

Cited by 4 publications

References 75 publications

Association Between Vitamin D Deficiency and Suspected Nonalcoholic Fatty Liver Disease in an Adolescent Population

Association Between Vitamin D Deficiency and Suspected Nonalcoholic Fatty Liver Disease in an Adolescent Population

Pathologic Impact of Insulin Resistance and Sensitivity on the Severity of Liver Histopathology in Pediatric Non-Alcoholic Steatohepatitis

The Efficacy of Pharmacological Treatment in Pediatric Nonalcoholic Fatty Liver Disease

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