Pediatric Nonalcoholic Fatty Liver Disease: the Rise of a Lethal Disease Among Mexican American Hispanic Children

Abstract

Hispanic children of Mexican origin have a high incidence of NAFLD. Susceptibility has been linked to a combination of factors including an increasing epidemic of obesity in children and adolescents, an allele substitution in the PNPLA3 gene that reduces hepatic lipid catabolism, and an altered microbiome that may increase hepatic endotoxins. The combination of NAFLD and portal vein toxins secondary to an indigenous gut microbiome appear to lead to the early occurrence of NASH, which progresses to cirrhosis and early hepatocellular carcinoma. Early detection and treatment of hepatic changes are needed. Given the success of gastric bypass in reducing body weight, modifying the gut microbiome, and improving NAFLD/NASH in adults, a trial of gastric bypass in predisposed pediatric candidates should be undertaken.

Ethnic influence on nonalcoholic fatty liver disease prevalence and lack of disease awareness in the United States, 2011–2016

“…We do surmise that our finding may be related to the age of our cohort and the use of NFS to stage fibrosis for this ethnicity. A most recent study using elastography to stage fibrosis found that the prevalence of fibrosis was highest amongst the younger aged Mexican Americans which highlights the burgeoning burden of NAFLD amongst Hispanic youth . Our findings may also be related to the high prevalence of impaired fasting glucose in our population, with more than 80% of persons with NAFLD having impaired fasting glucose.…”

Sex as a moderator of body composition following a randomized controlled lifestyle intervention among Latino youth with obesity

“…Latino youth are the fastest growing segment of the paediatric population in the United States and are disproportionately burdened by obesity and cardiometabolic disease risk . Despite similar prevalence rates of obesity, male and female Latino youth experience differential rates of obesity‐related diseases such as non‐alcoholic fatty liver disease (male > female), type 2 diabetes (T2D; female > male), and metabolic syndrome (male > female) . However, the mechanisms contributing to sex differences in disease risk among Latino youth are largely unknown.…”

Microarray Expression Profiling and Raman Spectroscopy Reveal Anti-Fatty Liver Action of Berberine in a Diet-Induced Larval Zebrafish Model

“…The pathogenesis of [ediatric NAFLD is still not fully understood. The scientific evidence indicates that a genetic predisposition interplaying with unhealthy diets and lifestyles might influence the occurrence and development of NAFLD in the pediatric population, mearly 50% of overweight children and adolescents accompanied by NAFLD (Betancourt-Garcia et al, 2017). In addition, insulin resistance and increased hepatic glucose production affect the hepatic de novo lipogenesis (Ciba and Widhalm, 2007).…”

“…The treatment approach is limited because of unclear pathogenesis of NAFLD and lack of therapeutic agents. Therefore, it is reasonable to develop suitable treatment strategies for children suffering from this disease (Betancourt-Garcia et al, 2017;Assuncao et al, 2017).…”