Pediatric nonalcoholic fatty liver disease (NAFLD): A “growing” problem?

Roberts, Eve A.

doi:10.1016/j.jhep.2007.03.003

Cited by 158 publications

(152 citation statements)

References 122 publications

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“…Most children (95%) in this cohort were overweight or obese. They displayed metabolic characteristics typical of NAFLD (Patton et al, 2006;Roberts, 2007): insulin resistance with hyperinsulinemia; dyslipidemia; hypoadipoinectinemia (Musso et al, 2005;Gilardini et al, 2006;Nakayama et al, 2009). WC, as such or expressed as waist-height ratio, was increased in all but one child.…”

Section: Discussionmentioning

confidence: 99%

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Dietary and physical activity patterns in children with fatty liver

Mager

Patterson

et al. 2010

Eur J Clin Nutr

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Background/Objectives: To examine lifestyle patterns (diet, physical activity, energy expenditure) and metabolic variables (insulin resistance, oxidative stress, inflammation) in children with fatty liver detected by sonography. Subjects/Methods: Body composition (fat-free mass, body mass index-z), waist circumference (WC), dietary intake and energy expenditure were determined in 38 patients (ages 5-19 years) with fatty liver in whom specific causative liver disorders had been excluded. Laboratory investigations included liver biochemistries, C-reactive protein, tumor necrosis factor-a, glutathione peroxidase, vitamin E, and erythrocyte-glutathione. Results: In all, 36 of 38 children were overweight/obese; 37 had WC indicative of abdominal obesity. They displayed fasting hyperinsulinemia (n ¼ 15), hypertriglyceridemia (n ¼ 14), and hypoadiponectinemia (5.5 ± 1.9 s.d. mg/ml; n ¼ 23) and insulin resistance (homeostasis model of insulin resistance (HOMA-IR)43; n ¼ 21). Alanine aminotransferase (ALT) was elevated in 28 (43-556 U/l; median ¼ 56). Some inflammatory markers were elevated, whereas antioxidants were decreased. Diet was characterized by high saturated-, low polyunsaturated-fat, high fructose and sucrose intakes. Fructose intake was independently associated with insulin resistance and decreased serum adiponectin, regardless of serum ALT (Po0.05). Low and subnormal intakes of omega-3 fatty acids (C20:5 (n-3) and C22:6 (n-3)) were associated with abnormal serum ALT (P ¼ 0.006) and elevated HOMA-IR (P ¼ 0.01). Findings were similar in children p11 and 411 years old. Physical activity was low in both age groups. Conclusions: Children with fatty liver detected sonographically have metabolic features of non-alcoholic fatty liver disease. Their diets are high in fructose and low in polyunsaturated fatty acid. Their activity patterns are sedentary. These lifestyle features may contribute to liver damage and can be a focus for therapeutic intervention.

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Section: Discussionmentioning

confidence: 99%

“…Thus, fatty liver severe enough to be identified sonographically deserves attention, at least in children. Unselected cross-sectional studies of children have found 2-3% prevalence of fatty liver by sonography, with much higher proportions in obese children (Roberts, 2007).…”

Section: Introductionmentioning

confidence: 99%

Dietary and physical activity patterns in children with fatty liver

Mager

Patterson

et al. 2010

Eur J Clin Nutr

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“…5,8 The presence and severity of fibrosis were consistently associated with a higher body mass index or larger waist circumference 15,21,26 and had some relation to older age, higher levels of aspartate aminotransferase and insulin. 27,29 These 'fibrosis predictors' have ranged from 10 to 25% of elevated ALT in obese adolescence to 52-77% bright liver, in sonography, in different studies in several countries.…”

Section: Pediatric Nonalcoholic Fatty Liver K Widhalm and E Ghodsmentioning

confidence: 99%

“…30,31 Some of the characteristics of pediatric NAFLD may partly be because of the occurrence of hepatic metabolic derangements, typical of NAFLD, during periods of active growth (infancy, mid-childhood and puberty). 6,8,26 Unlike adults, the majority of children have portal-based injuries on liver biopsies. 5,28 The importance of pediatric NAFLD extends beyond the highly probable increased burden of serious chronic liver disease as children with NAFLD reach adulthood.…”

Section: Pediatric Nonalcoholic Fatty Liver K Widhalm and E Ghodsmentioning

confidence: 99%

“…10 After controlling for gender, race, and ethnicity, its prevalence increased with age ranging from 0.7% for ages 2-4 years up to 17.3% for ages of 15-19. 8,19 The pediatric fatty liver disease has shown a male predominance on the basis of pathology 9,26 and higher abnormal alanine transaminase (ALT) (males: females, 44-7%). 9 Biopsy-proven NAFLD has a ratio of 2.2:1 in boys to girls on the basis of linking of clinical cases from four different continents.…”

Section: Introductionmentioning

confidence: 99%

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Nonalcoholic fatty liver disease: a challenge for pediatricians

Widhalm

Ghods

2010

Int J Obes

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Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Its prevalence is related to the growing epidemic in childhood obesity during the past decades. At present, NAFLD and nonalcoholic steatohepatitis (NASH) are increasingly recognized worldwide. In spite of alarming trend in the epidemiology in pediatric field and growing risk of end stage liver disease, there is no significant advance in its diagnosis and treatment. Aim: To provide a detailed review for diagnosis and management of NAFLD and NASH. Methods: By using Pubmed to find review articles and relevant research. Results: The prevalence ranges from at least 3% in children overall to about 50% in obese children. The noninvasive biomarkers can be used to identify NAFLD/NASH patients. Diagnostic criteria based on biochemical and immunological indicators in the high-risk group of children could prevent about half of cases from receiving an invasive test. The pharmacological and surgical interventions have shown a growing role in pediatric NAFLD. Novel treatment modalities, such as probiotics, have hardly been studied. Conclusion: Early diagnosis by using noninvasive screening methods in high-risk groups is the most effective strategy against the NAFLD. The biology of early growth and development, including hepatic metabolism, may hold the key to pediatric NAFLD. Prevention of overweight children and childhood obesity is undoubtedly the best strategy for treating NAFLD.

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Obesity and its Hepatic Complications in Adults and Children

Heathcote¹,

Roberts

2012

Hepatology: Diagnosis and Clinical Management

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Pediatric nonalcoholic fatty liver disease (NAFLD): A “growing” problem?

Cited by 158 publications

References 122 publications

Dietary and physical activity patterns in children with fatty liver

Dietary and physical activity patterns in children with fatty liver

Nonalcoholic fatty liver disease: a challenge for pediatricians

Obesity and its Hepatic Complications in Adults and Children

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