The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years

Feldstein, Ariel E.; Charatcharoenwitthaya, Phunchai; Treeprasertsuk, Sombat; Benson, Joanne T.; Enders, Felicity; Angulo, Paul

doi:10.1136/gut.2008.171280

Cited by 634 publications

(481 citation statements)

References 45 publications

Supporting

Mentioning

459

Contrasting

Unclassified

Order By: Relevance

“…While most authorities agree that steatosis alone is not a risk for progressive liver disease, in fact, published series have shown progressive fibrosis in a small number of patients over several years of follow-up [29,30]. A 20-year pediatric natural history study utilizing liver biopsy has confirmed the risk of cirrhosis as well as recurrence of NAFLD in the transplanted liver in affected children [31]. …”

Section: Liver Biopsy Evaluation In Clinical Investigation: Prevalencmentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease: What the Pathologist Can Tell the Clinician

Brunt

2012

Dig Dis

View full text Add to dashboard Cite

Liver biopsy evaluation continues to serve a significant, often primary, role in clinical care, as well as in fundamental aspects of investigation in nonalcoholic fatty liver disease (NAFLD). This is a review of the major features of liver pathology in NAFLD and specifically what role liver biopsy continues to play in both clinical management and scientific investigation. Diagnostic criteria for NAFLD and nonalcoholic steatohepatitis in adults and children are discussed, as are other histologic features that may be encountered. Histologic features for diagnostic classification(s) of NAFLD and semiquantitative methods of assessment are reviewed. The unique patterns of injury and fibrosis that characterize this disease are emphasized, and reasons why histologic scoring and diagnosis are considered as interrelated but separate exercises given. In addition, pros and cons and recognized limitations of liver biopsy in NAFLD are discussed.

show abstract

Section: Liver Biopsy Evaluation In Clinical Investigation: Prevalencmentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease: What the Pathologist Can Tell the Clinician

Brunt

2012

Dig Dis

View full text Add to dashboard Cite

show abstract

“…Limited data suggests that children diagnosed with NAFLD have increased morbidity and mortality rates in adulthood (9). NASH can cause severe complications such as cirrhosis (1).…”

Section: Nafldmentioning

confidence: 99%

Treatment of Nonalcoholic Fatty Liver Disease in Children: A Systematic Review

Shahmirzadi

Barati

2017

J Pediatr Rev

View full text Add to dashboard Cite

Context: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver illness that results from exceeding fat cumulating in the liver. NAFLD can result in progressive fibrosis, which leads to end-stage liver disease. It has rapidly evolved into the most common liver disease seen in the pediatric and adolescent population, being an increasingly common indication for liver transplant even in youths. Best practices in the management of pediatric NAFLD have not been clearly defined.Objectives: Due to increasing prevalence and the nature of the disease as well as importance of treatment plans and efficacy of each mode of treatment, all studies for pediatric fatty liver disease have been investigated for introducing definite or potential therapies. Data Sources:This systematic review aimed to include and analyze all studies descry the effectiveness of lifestyle modification, pharmacological, non-pharmacological, and dietary supplement treatments in children suffered from fatty liver, NAFLD, or NASH. The PUBMED/MEDLINE for Controlled Trials, Scopus, and OVID databases were searched for articles published up to and including December 2016.Study Selection, Data Extraction: All study in the pediatric group with diagnosis of fatty liver spectrum were included in this review. Adult studies were excluded. The results extracted and expanded.Results: A total of 27 randomized controlled trials were identified after the complete search, deletion of duplicates, removal of irrelevant studies, and final assessment of studies. Treatment plans of interest in these pediatrics articles included: lifestyle modifications, fish oil, and omega-3 fatty acids, including docosahexaenoic acid (DHA), probiotics, vitamin E, metformin, ursodeoxycholic acid, vitamin D, and bariatric surgery. Conclusions:Lifestyle modification is the only approved treatment modality for which evidence-based studies have documented benefits. Omega-3 fatty acids, particularly DHA, are probably effective. Probiotics likely have therapeutic effects in cases of fatty liver; however, further research is needed. Vitamin E and metformin have equivocal results. Ursodeoxycholic acid is recommended as an adjuvant; however, the data are insufficient for vitamin D. Bariatric surgery is not an acceptable plan in pediatric patients. Research of fatty liver diseases in children in all aspects of treatments is urgently needed.

show abstract

“…Indeed, it is now largely accepted that NAFLD represents the hepatic features of the metabolic syndrome and is associated with increased mortality [5,6]. …”

Section: Introductionmentioning

confidence: 99%

Early Glucose Derangement Detected by Continuous Glucose Monitoring and Progression of Liver Fibrosis in Nonalcoholic Fatty Liver Disease: An Independent Predictive Factor?

et al. 2015

View full text Add to dashboard Cite

Background: Glucose derangement has been reported to increase oxidative stress, one of the most important factors underlying the progression of hepatic fibrosis in adults with nonalcoholic fatty liver disease (NAFLD). To date, careful evaluation of the glucose profile in pediatric NAFLD has not been performed. Methods: A total of 30 severely obese children (15 males; mean age 12.87 ± 2.19 years) with biopsy-proven NAFLD were enrolled in this study from September to December 2013. All patients underwent anthropometric and laboratory evaluation, including the oral glucose tolerance test (OGTT) and continuous glucose monitoring (CGM). Results: Our study reveals some differences between OGTT and CGM in detecting NAFLD children with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). OGTT showed 2 (6.67%) patients with IFG and 1 (3.34%) with IGT, while CGM showed 5 (16.67%) patients with IFG and 6 (20%) with IGT. The daily blood glucose profile positively correlated with the baseline blood glucose (r = 0.39, p = 0.04) and the homeostatic model assessment (r = 0.56, p = 0.05). A positive correlation between hyperglycemia and liver fibrosis was found (r = 0.65, p < 0.05). Mean glucose values (F3-F4 group: 163.2 ± 35.92 mg/dl vs. F1 group: 136.58 ± 46.83 mg/dl and F2 group: 154.12 ± 22.51 mg/dl) and the difference between the minimum and maximum blood glucose levels (F3-F4 group: 110.21 ± 25.26 mg/dl vs. F1 group: 91.67 ± 15.97 mg/dl and F2 group: 92 ± 15.48 mg/dl) were significantly (p < 0.05) higher in the F3-F4 group compared to the F1 and F2 groups. Conclusion: Glucose profile derangement as detected by CGM is associated with the severity of hepatic fibrosis in children with NAFLD.

show abstract

The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years

Cited by 634 publications

References 45 publications

Nonalcoholic Fatty Liver Disease: What the Pathologist Can Tell the Clinician

Nonalcoholic Fatty Liver Disease: What the Pathologist Can Tell the Clinician

Treatment of Nonalcoholic Fatty Liver Disease in Children: A Systematic Review

Early Glucose Derangement Detected by Continuous Glucose Monitoring and Progression of Liver Fibrosis in Nonalcoholic Fatty Liver Disease: An Independent Predictive Factor?

Contact Info

Product

Resources

About