Metabolic Fatty Liver Disease in Children: A Growing Public Health Problem

Garf, Sébastien Le; Nègre, Véronique; Anty, Rodolphe; Gual, Philippe

doi:10.3390/biomedicines9121915

Cited by 25 publications

(26 citation statements)

References 89 publications

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“…Despite the efforts done by several scientific research groups, there are currently no effective pharmacologic therapies and subsequently no current clinical practice guidelines' recommendations, regarding the medications/ supplementations used in the treatment of pediatric NAFLD (4,6). Weight loss and increased physical activity through lifestyle modification and a well-balanced diet still remains the mainstay of pediatric NAFLD management (4,6,24). The results of our study denote that probiotics might have a beneficial effect in the treatment of pediatric NAFLD by decreasing liver transaminases' levels and by improving individual parameters of the metabolic syndrome.…”

Section: Discussionmentioning

confidence: 99%

The Benefit of Probiotics in Pediatric Nonalcoholic Fatty Liver Disease: A Meta-analysis of Randomized Control Trials

Gkiourtzis

Vadarlis

Bakaloudi

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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Objectives: We conducted a systematic review and meta-analysis to provide a summary of the current literature about the efficacy of probiotics in pediatric nonalcoholic fatty liver disease (NAFLD). Methods: A systematic literature search through major electronic databases was carried out for RCTs till September 9, 2021, investigating the efficacy of probiotics in the treatment of pediatric patients with NAFLD. Weighted mean differences (WMD) and Standard Deviations (SD) were used to calculate continuous outcomes and a Risk Ratio with 95% CI was used for dichotomous outcomes. Results: In total, 4 RCTs with 238 pediatric patients with NAFLD were included in the study. Probiotic supplementation revealed a statistically significant difference in transaminases' levels (ALT: WMD = -7.51 IU/L, 95% CI, -11.28 to -3.73, I 2 = 0%, P < 0.0001; AST: WMD = -6.46 IU/L, 95% CI, -9.31 to -3.61, I 2 = 0%, P < 0.00001), anthropometric characteristics, total cholesterol, triglycerides and ultrasonographic steatosis improvement. Conclusions: According to the data of this meta-analysis, probiotic supplementation, and especially supplementation of Lactobacillus acidophilus in combination with other strains of Bifidobacterium or Lactobacillus may be beneficial in the improvement of transaminases', lipid parameters' levels, ultrasonographic, and anthropometric characteristics in children with NAFLD. Current evidence does not allow specifying the exact beneficial strain of probiotics mentioned above. The possible effect of probiotics on liver histology improvement in pediatric NAFLD should be examined in future studies.

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Section: Discussionmentioning

confidence: 99%

The Benefit of Probiotics in Pediatric Nonalcoholic Fatty Liver Disease: A Meta-analysis of Randomized Control Trials

Gkiourtzis

Vadarlis

Bakaloudi

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

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“…The nephrotic state is associated with hyperlipidemia 20 and obesity is generally a worrying problem in children and adolescents worldwide. 38,39 Kirpalani et al 20 observed increased MPA CL/F values along with lower albumin concentrations and haematocrit as well as higher triglycerides and cholesterol. We found a few correlations between the cholesterol and the pharmacokinetic and pharmacodynamic parameters as well as higher cholesterol in younger children.…”

Section: Discussionmentioning

confidence: 98%

Inosine monophosphate dehydrogenase activity and mycophenolate pharmacokinetics in children with nephrotic syndrome treated with mycophenolate mofetil

Sobiak

Resztak

Zachwieja

et al. 2022

Clin Exp Pharma Physio

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Some studies have shown that the area under the concentration-time curve (AUC) of mycophenolic acid (MPA) should be higher for children with nephrotic syndrome (NS) than after renal transplantation. The pharmacodynamic aspect of MPA, the activity of inosine monophosphate dehydrogenase (IMPDH), has not been studied in children with NS. The study included 21 children (4-16 years old) with NS treated with mycophenolate mofetil. MPA and its glucuronide plasma concentrations were determined using validated high-performance liquid chromatography-ultraviolet (HPLC-UV). The separate HPLC-UV method was applied for IMPDH activity determination. The variability was expressed by the coefficient of variation (CV). IMPDH activity and MPA concentration (C trough ) before the morning dose amounted to 29.95 μmol s À1 mol À1 adenosine monophosphate (AMP) (range, 6.71-98.60 μmol s À1 mol À1 AMP) and 1.72 μg/mL (range, 0.39-4.34 μg/mL), respectively, whereas the area under the effect-time curve from 0 to 4 h and MPA AUC 0-4 were 130.36 μmol s À1 mol À1 AMP Â h (range, 23.58-306.57 μmol s À1 mol À1 AMP Â h) and 24.63 μg h/mL (range, 12.21-67.48 μg h/mL), respectively. IMPDH activity decreased concomitantly with MPA concentration increase, however, the variability of the pharmacodynamic parameters was greater than of the pharmacokinetics. The median degree of maximum IMPDH inhibition was 61%. MPA C trough and predicted AUC were lower than in our previous study. Only a few MPA pharmacokinetic parameters correlated with the pharmacodynamics. IMPDH activity did not correlate with the children's age and did not differ between boys and girls. MPA clearance was the highest in younger children (median, 10.54 L/m 2 /h) and cholesterol correlated negatively with the children's age (r = À0.659, P = 0.003). IMPDH minimum activity and the degree of maximum IMPDH inhibition were similar to those obtained in renal transplant recipients. IMPDH activity does not undergo developmental or gender-specific regulation in children with NS. MPA underexposure might be more frequent in younger children, especially with high cholesterol and triglycerides levels because of high MPA clearance.

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“…High calories, carbohydrates, and fat increase the prevalence of chronic diseases associated with insulin resistance, such as NAFLD [25,38,40]. The increased consumption of sweetened beverages, particularly among children and adolescents, leads to increased fructose adsorption with increased lipogenesis, triglycerides accumulation, and liver damage due to its metabolism [41]. Moreover, macronutrient composition in the diet can impact the incidence of these chronic diseases without affecting body weight [38].…”

Section: Discussionmentioning

confidence: 99%

Trends in Prediabetes and Non-Alcoholic Fatty Liver Disease Associated with Abdominal Obesity among Korean Children and Adolescents: Based on the Korea National Health and Nutrition Examination Survey between 2009 and 2018

et al. 2022

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Investigations on the trends of prediabetes and non-alcoholic fatty liver disease (NAFLD) among children are scarce. We aimed to analyze the trends of prediabetes and NAFLD, as well as their association, among Korean children and adolescents from 2009 to 2018. This study investigated the prevalence of prediabetes, NAFLD, and abdominal obesity among 6327 children and adolescents aged 10–18 years according to age, sex, and body mass index (BMI) using a nationally representative survey. The prevalence of prediabetes, NAFLD, and abdominal obesity increased from 5.14%, 8.17%, and 5.97% respectively, in 2009 to 10.46%, 12.05%, and 10.51% respectively, in 2018. In age-specific analyses, an adverse trend in NAFLD was significant only in participants aged 16–18 years while the prevalence of prediabetes worsened significantly in all age groups. In BMI-specific analyses, the prevalence of prediabetes and NAFLD increased significantly only in participants with normal BMI. In logistic regression analysis, the odds ratio of prediabetes for NAFLD was 1.85 and those of abdominal obesity for prediabetes and NAFLD was 1.85 and 9.34, respectively. Our results demonstrated that the prevalence of prediabetes and NAFLD was increasing in association with abdominal obesity in Korean children and adolescents.

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Metabolic Fatty Liver Disease in Children: A Growing Public Health Problem

Cited by 25 publications

References 89 publications

The Benefit of Probiotics in Pediatric Nonalcoholic Fatty Liver Disease: A Meta-analysis of Randomized Control Trials

The Benefit of Probiotics in Pediatric Nonalcoholic Fatty Liver Disease: A Meta-analysis of Randomized Control Trials

Inosine monophosphate dehydrogenase activity and mycophenolate pharmacokinetics in children with nephrotic syndrome treated with mycophenolate mofetil

Trends in Prediabetes and Non-Alcoholic Fatty Liver Disease Associated with Abdominal Obesity among Korean Children and Adolescents: Based on the Korea National Health and Nutrition Examination Survey between 2009 and 2018

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