Pathologic Impact of Insulin Resistance and Sensitivity on the Severity of Liver Histopathology in Pediatric Non-Alcoholic Steatohepatitis

Park, Byung Han; Yoon, Jung Min; Kim, Ja Hye; Moon, Jeong-Ho; Lee, Young Ho; Jang, Sang Ock; Kim, Yong Joo

doi:10.3349/ymj.2017.58.4.756

Cited by 12 publications

(14 citation statements)

References 47 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Estimated prevalences of fibrosis were 21% with an ALT level > 30 U/L for boys and > 19 U/L for girls ( P < 0.001); 21.3% with an ALT level > 30 U/L for boys and > 19 U/L for girls ( P < 0.001); 23% with an ALT level > 40 U/L for both sexes ( P < 0.001); and 24.5% with an ALT level > 30 U/L for both sexes ( P < 0.001). 18 20 …”

Section: Resultsmentioning

confidence: 99%

Estimated Prevalence of Adolescents with Nonalcoholic Fatty Liver Disease in Korea

et al. 2018

View full text Add to dashboard Cite

BackgroundNonalcoholic fatty liver disease (NAFLD) has become prevalent worldwide in the last decade. However, the recent prevalence of NAFLD in adolescents has not yet been investigated in Korea.MethodsData were obtained from 1,416 participants aged 10–18 years from the Korea National Health and Nutrition Examination Survey conducted in 2010 and 2015. Systolic blood pressure (SBP), diastolic blood pressure (DBP), height, weight, waist circumference (WC), body mass index (BMI), fasting glucose, total cholesterol, high-density lipoprotein (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT) level, waist-to-height ratio (WHtR), and pediatric NAFLD fibrosis index (PNFI) were analyzed.ResultsSBP, weight, WC, BMI, WHtR, and total cholesterol level were significantly higher in 2015 than in 2010. Prevalence of NAFLD (BMI ≥ 85th percentile plus ALT > 30 U/L for boys and ALT > 19 U/L for girls) were 4.7% in 2010 and 5.9% in 2015 (P = 0.360). Using various cutoffs for the ALT level (> 40, > 30, > 25.8 U/L for boys and >22.1 U/L for girls) NAFLD prevalence rates were 3.0%, 4.1%, and 5.5% in 2010; 2.9%, 5.0%, and 7.1% in 2015, respectively (P = 0.899, 0.469, and 0.289). Boys had a higher SBP, DBP, height, weight, WC, BMI, WHtR, fasting glucose, total cholesterol, ALT, and lower HDL level than girls. The probability of liver fibrosis using the PNFI varies between 21.3% and 24.5% among NAFLD participants (P < 0.001).ConclusionThe Korean society needs to quickly control the increasing prevalence of NAFLD in adolescents and reduce its complications.

show abstract

Section: Resultsmentioning

confidence: 99%

Estimated Prevalence of Adolescents with Nonalcoholic Fatty Liver Disease in Korea

et al. 2018

View full text Add to dashboard Cite

show abstract

“…However, ALT has been recommended as a screening tool for NAFLD and has previously been used for population-based epidemiological studies. [ 7 , 8 , 17 ] Furthermore, the upper normal limits of ALT (24.1 U/L for boys and 17.7 U/L for girls) should be validated using liver biopsies [ 7 , 18 ]. Second, the KNHANES data do not include information regarding the use of hepatotoxic medication.…”

Section: Discussionmentioning

confidence: 99%

Normal serum alanine aminotransferase and non-alcoholic fatty liver disease among Korean adolescents: a cross-sectional study using data from KNHANES 2010–2015

et al. 2018

View full text Add to dashboard Cite

BackgroundNon-alcoholic fatty liver disease (NAFLD) is complicated disease and increasing worldwide. Previously, many studies of NALFD prevalences have used alanine aminotransferase (ALT) of > 40 U/L to define NAFLD, although that is too high to be reliable among adolescents. This study aimed to define the upper normal limit of ALT among Korean adolescents, and use it to estimate the prevalence of NAFLD, based on data from the Korea National Health and Nutrition Examination Survey (KNHANES).MethodsData were obtained from 1785 healthy adolescents (916 boys and 869 girls, 10–18 years old) who participated in the KNHANES during 2010–2015. The International Diabetes Federation metabolic syndrome criteria for adolescents were used to exclude participants with metabolic syndrome components. Furthermore, participants who previously had diseases related to low HDL levels, high TG levels, diabetes, or very low/high body mass index and hepatitis B were excluded. The 95th percentiles level of ALT from healthy participants were evaluated. The definition of NAFLD was overweight status (≥85th percentile of body mass index) plus elevated ALT levels (95th percentile).ResultsThe upper normal ALT were 24.1 U/L for boys and 17.7 U/L for girls. Based on these values, the estimated prevalences of NAFLD in 2015 were 8.9% among adolescents.ConclusionDefining the upper normal limit of ALT can be adjusted for each sex and ethnics in the general population. ALT laboratory thresholds used for children should be re-examined. The physicians should be aware not to underdiagnose NAFLD patient even ALT level is < 40 U/L.

show abstract

“…NAFLD is considered a 'hepatic manifestation of metabolic syndrome' . It is very closely related to type 2 diabetes or metabolic syndrome, and the main pathophysiology underlying this relationship is known to be insulin resistance [37,38]. The association is considerably strong that NAFLD is present even in obese adolescents with dysglycemia [39].…”

Section: Results In Relation To Other Studiesmentioning

confidence: 99%

Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study

Lee

Cho

Choi³

et al. 2020

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background: There is increasing concern regarding cardiovascular risk in individuals with non-alcoholic fatty liver disease. This study was conducted to evaluate whether hepatic steatosis with or without fibrosis is associated with the progression of carotid atherosclerosis in patients with type 2 diabetes. Methods: From a longitudinal cohort, we enrolled 1120 patients with type 2 diabetes who underwent repeated carotid artery ultrasonography every 1-2 years. Ultrasonographic findings at baseline and after 6-8 years were compared. Presence of hepatic steatosis was mainly assessed by abdominal ultrasonography; patients with hepatic steatosis were further evaluated for hepatic fibrosis according to fibrosis-4 index. We investigated the association between liver status and atherosclerosis progression. Results: Of 1120 patients, 636 (56.8%) were classified as having hepatic steatosis at baseline. After 6-8 years, 431 (38.5%) showed atherosclerosis progression. Hepatic steatosis was significantly associated with atherosclerosis progression (adjusted odds ratio[AOR]: 1.370, 95% CI 1.025-1.832; p < 0.05). Among patients with hepatic steatosis, only individuals with fibrosis showed significant association with atherosclerosis progression (AOR: 1.615, 95% CI 1.005-2.598; p < 0.05). The association between hepatic fibrosis and atherosclerosis progression was significant in all metabolic subgroups regardless of age, body mass index, presence of metabolic syndrome, or insulin sensitivity (all p < 0.05). Furthermore, subjects with hepatic steatosis & fibrosis and ≥ 4 components of metabolic syndrome criteria showed markedly increased risk of atherosclerosis progression (AOR: 2.430, 95% CI 1.087-5.458; p < 0.05). Conclusions: Hepatic steatosis with fibrosis is independently associated with the progression of carotid atherosclerosis in patients with type 2 diabetes.

show abstract

Pathologic Impact of Insulin Resistance and Sensitivity on the Severity of Liver Histopathology in Pediatric Non-Alcoholic Steatohepatitis

Cited by 12 publications

References 47 publications

Estimated Prevalence of Adolescents with Nonalcoholic Fatty Liver Disease in Korea

Estimated Prevalence of Adolescents with Nonalcoholic Fatty Liver Disease in Korea

Normal serum alanine aminotransferase and non-alcoholic fatty liver disease among Korean adolescents: a cross-sectional study using data from KNHANES 2010–2015

Non-alcoholic steatohepatitis and progression of carotid atherosclerosis in patients with type 2 diabetes: a Korean cohort study

Contact Info

Product

Resources

About