Metabolic syndrome and liver histology in paediatric non-alcoholic steatohepatitis

Manco, Melania; Marcellini, Matilde; Vito, Rita De; Comparcola, Donatella; Sartorelli, Maria Rita; Nobili, Valério

doi:10.1038/sj.ijo.0803711

Cited by 164 publications

(110 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…38 NASH is significantly associated with the presence of insulin resistance and a metabolic syndrome in ob children. 39,40 The significant relation between fasting insulin, insulin resistance and NAFLD in ob children underlines the clinical dimension of these metabolic disturbances. 41 In the German Guidelines, fasting insulin is not recommended during a primary care visit.…”

Section: Discussionmentioning

confidence: 99%

Obese boys at increased risk for nonalcoholic liver disease: evaluation of 16 390 overweight or obese children and adolescents

et al. 2010

View full text Add to dashboard Cite

Objective: Comorbidities of childhood obesity challenge health-care systems in Europe. Further, there is a lack of populationspecific prevalence data and diagnostic strategies available, especially for obesity-related disturbances of liver function. Therefore, the prevalence of elevated liver enzymes and their relationship to biological parameters were studied in a large pediatric obesity cohort. Methods: In 111 specialized pediatric obesity centers in Germany, Austria and Switzerland, 16 390 children and adolescents (age 12.4 ± 2.6 years, 58% boys) were categorized as overweight (body mass index (BMI) 490th percentile) and obese (497th percentile) and studied for related comorbidities, especially nonalcoholic fatty liver disease (NAFLD; as defined by aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) 450 U l À1 ). Data were collected using a standardized software program (APV) for longitudinal multicenter documentation. Pseudonymized data were transmitted for central statistical analysis. Results: In this pediatric cohort, 16% of the study population was overweight, 46% obese and 35% extremely obese (499.5th percentile extreme obesity (Xob)). NAFLD was present in 11% of the study population, but predominantly in boys (boys vs girls; 14.4:7.4%; Po0.001), in Xob (obese vs Xob; 9.5:17.0%; Po0.001) and in older age (o 12 vs X12 years; 8:12%; Po0.001; adjusted for BMI). ALT 450 U l À1 was significantly associated with fasting insulin and BMI-SDS. In multiple logistic regression models, Xob and male gender were strongly associated with NAFLD (odds ratio Xob vs normal weight ¼ 3.2; boys vs girls OR ¼ 2.3). Conclusion: In a large cohort of overweight and obese European children and adolescents, markers of nonalcoholic liver disease, especially ALT, are frequent and predicted by Xob and male gender. The results underline the epidemiological dimension of this obesity-related morbidity even in childhood. Therefore, at least ALT is recommended as a screening parameter in basic care.

show abstract

Section: Discussionmentioning

confidence: 99%

Obese boys at increased risk for nonalcoholic liver disease: evaluation of 16 390 overweight or obese children and adolescents

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Interrelationships between NAFLD, metabolic syndrome, insulin resistance, and WC Manco et al [28] conducted a cohort study and concluded that metabolic syndrome, insulin resistance, and NAFLD in children were interrelated. In their cohort study, Hamaguchi et al [29] showed that metabolic syndrome is a predictor for NAFLD.…”

Section: Waist Circumference and Nafldmentioning

confidence: 99%

“…Data were collected on three school-day mornings (October [26][27][28]1994). Weight (kg), WC (cm), height (m), and blood pressure (BP: mmHg) were measured following the guideline of the Japanese Ministry of Health, Welfare and Labor [12].…”

Section: Data Collectionmentioning

confidence: 99%

Prevalence of non-alcoholic fatty liver disease in children and relationship to metabolic syndrome, insulin resistance, and waist circumference

Tominaga

Fujimoto

Suzuki

et al. 2009

Environ Health Prev Med

View full text Add to dashboard Cite

Objectives To investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) in children and its relationship to metabolic syndrome, insulin resistance, and waist circumference (WC). Methods This was a population-based cross-sectional, case-control study. Cases were selected among students of a primary and junior high school, respectively, and ageand sex-matched control subjects were selected randomly (ratio of cases to control subject was 37:113). Results Of the 846 students, aged between 6 and 15 years, enrolled in the study and screened by ultrasonography, 37 children were diagnosed as having NAFLD (score C 1). There was a significant sex difference in the prevalence of NAFLD(P = 0.003). The trend test revealed a strong doseresponse relationship (P \ 0.001) between pediatric NA-FLD and the number of the proposed components of pediatric metabolic syndrome in Japan (MetS-JC), such as a clustering of the components of MetS-JC. Additionally, the linear trend of the odds ratios (ORs) with increasing percentile of the homeostasis model assessmentinsulin resistance (HOMA-IR) was statistically significant (P \ 0.001). However, when WC was added to the logistic model, the ORs were no longer significant, whereas WC turned out to be an independent risk factor for NAFLD regardless of the HOMA-IR index. Conclusion The prevalence of NAFLD in children and adolescents is closely related to metabolic syndrome, insulin resistance, and WC.

show abstract

“…Most NAFLD children are asymptomatic and the few signs and symptoms that are observed are often nonspecific. NAFLD is a multifactorial disease that clinically may or may not comprise elevated serum ALT levels, hyperlipidemia, hyperglycemia and insulin resistance, associated with increased body weight and echogenic liver that is suggestive of hepatic steatosis [13][14][15] . Over the initial period of disease, many patients progress to the more advanced form of NAFLD, which combines the mentioned dysmetabolic pattern with severe liver injury, including steatohepatitis, necroinflammation and fibrosis [16] .…”

Section: Wwwwjgnetcommentioning

confidence: 99%

Pediatric non-alcoholic fatty liver disease: Preventive andtherapeutic value of lifestyle intervention

Nobili¹,

Alisi²,

Raponi³

2009

WJG

View full text Add to dashboard Cite

Nonalcoholic fatty liver disease (NAFLD), ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), and eventually cirrhosis and liver failure, is seen to be increasing amongst Western children. NAFLD rates are rising in parallel with the epidemic of childhood obesity, and in particular, fatty liver evolves more easily in NASH when poor dietary habits and sedentary lifestyle are combined. In fact, its general prevalence in the child population varies between 2.6% and 10%, but increases up to 80% in obese children. Since NASH is expected to become the most common cause of pediatric chronic liver disease in the near future, there is broad interest amongst clinical researchers to move forward, both in diagnosis and treatment. Unfortunately, to date, the expensive and invasive procedure of liver biopsy is seen as the gold standard for NASH diagnosis and few noninvasive diagnostic methods can be applied successfully. Moreover, there are still no approved pharmacological interventions for NAFLD/NASH. Therefore, current management paradigms are based upon the presence of associated risk factors and aims to improve an individual's quality of life, thus reducing NAFLD-associated morbidity and mortality. Today, lifestyle intervention (diet and exercise) is the treatment of choice for NAFLD/ NASH. Thus far, no study has evaluated the potential preventive effect of lifestyle intervention on children at risk of NAFLD/NASH. Future studies will be required in this area with the perspective of developing a national program to promote nutrition education and increase physical activity as means of preventing the disease in individuals at risk. Here, we outline the clinical course, pathogenesis and management of NAFLD in children, highlighting the preventive and therapeutic value of lifestyle intervention.

show abstract

Metabolic syndrome and liver histology in paediatric non-alcoholic steatohepatitis

Cited by 164 publications

References 31 publications

Obese boys at increased risk for nonalcoholic liver disease: evaluation of 16 390 overweight or obese children and adolescents

Obese boys at increased risk for nonalcoholic liver disease: evaluation of 16 390 overweight or obese children and adolescents

Prevalence of non-alcoholic fatty liver disease in children and relationship to metabolic syndrome, insulin resistance, and waist circumference

Pediatric non-alcoholic fatty liver disease: Preventive andtherapeutic value of lifestyle intervention

Contact Info

Product

Resources

About