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paediatric nafld

S Francque, N Lanthier, L Verbeke, H Reynaert, C Van Steenkiste, L Vonghia, W J Kwanten, J Weyler, E Trépo, D Cassiman, F Smets, M Komuta, A Driessen, E Dirinck, E Danse, B Op de Beeck, E van Craenenbroeck, Y Van Nieuwenhove, G Hubens, A Geerts, C Moreno
Non-Alcoholic Fatty Liver Disease (NAFLD) is highly prevalent and associated with considerable liver-related and non-liverrelated morbidity and mortality. There is, however, a lot of uncertainty on how to handle NAFLD in clinical practice. The current guidance document, compiled under the aegis of the Belgian Association for the Study of the Liver by a panel of experts in NAFLD, from a broad range of different specialties, covers many questions encountered in daily clinical practice regarding diagnosis, screening, therapy and follow-up in adult and paediatric patients...
January 2018: Acta Gastro-enterologica Belgica
Christos Spanos, Elaina M Maldonado, Ciarán P Fisher, Petchpailin Leenutaphong, Ernesto Oviedo-Orta, David Windridge, Francisco J Salguero, Alexandra Bermúdez-Fajardo, Mark E Weeks, Caroline Evans, Bernard M Corfe, Naila Rabbani, Paul J Thornalley, Michael H Miller, Huan Wang, John F Dillon, Alberto Quaglia, Anil Dhawan, Emer Fitzpatrick, J Bernadette Moore
Background: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide. However, its molecular pathogenesis is incompletely characterized and clinical biomarkers remain scarce. The aims of these experiments were to identify and characterize liver protein alterations in an animal model of early, diet-related, liver injury and to assess novel candidate biomarkers in NAFLD patients. Methods: Liver membrane and cytosolic protein fractions from high fat fed apolipoprotein E knockout (ApoE-/- ) animals were analyzed by quantitative proteomics, utilizing isobaric tags for relative and absolute quantitation (iTRAQ) combined with nano-liquid chromatography and tandem mass spectrometry (nLC-MS/MS)...
2018: Proteome Science
Valerio Nobili, Piotr Socha
Nonalcoholic fatty liver disease (NAFLD), an increasingly prevalent paediatric disorder, is diagnosed and managed not only by both pediatric gastroenterologists/hepatologists but also frequently by the general pediatrician. This article updates recent advances in diagnostic and therapeutic approach, which may be applied to everyday practice. Diagnosis of NAFLD takes into account the risk factor profile and is a diagnosis of exclusion. Techniques such as transient elastography and specific biomarkers aimed at improving diagnosis and monitoring of NAFLD need further validation in the pediatric population...
February 2018: Journal of Pediatric Gastroenterology and Nutrition
Shui-Xian Du, Lin-Lin Lu, Ning Geng, David W Victor, Li-Zhen Chen, Cong Wang, Hai-Yan Yue, Yong-Ning Xin, Shi-Ying Xuan, Wen-Wen Jin
BACKGROUND: A growing number of studies reported the connection between the level of serum ferritin (SFL) and non-alcoholic fatty liver disease (NAFLD). However, such connection was still disputable. The aim of our meta-analysis was to estimate SFL between the groups as below: patients with NAFLD against control group; non-alcoholic steatohepatitis (NASH) patients against control group; non-alcoholic fatty liver (NAFL) patients against a control group and NASH patients vs NAFL patients...
December 2, 2017: Lipids in Health and Disease
Valerio Nobili, Piotr Socha
Non-alcoholic fatty liver disease (NAFLD), an increasingly prevalent paediatric disorder is diagnosed and managed by both paediatric gastroenterologists / hepatologists but also frequently by the general paediatrician. This paper updates recent advances in diagnostic and therapeutic approach which may be applied to everyday practice. Diagnosis of NAFLD takes into account the risk factor profile and is a diagnosis of exclusion. Techniques such as transient elastography and specific biomarkers aimed at improving diagnosis and monitoring of NAFLD need further validation in the paediatric population...
October 31, 2017: Journal of Pediatric Gastroenterology and Nutrition
Jasmine A Jackson, Juna V Konomi, Michael V Mendoza, Alyssa Krasinskas, Ran Jin, Shelley Caltharp, Marialena Mouzaki, Miriam B Vos
AIM: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in children. The phenotype of NAFLD varies widely, and non-invasive predictors of disease severity are scarce and are needed to tailor clinical management. METHODS: We compared liver fibrosis by histology with proposed non-invasive predictors of fibrosis, including alanine transaminase (ALT), aspartate transaminase (AST), AST/ALT ratio, AST to platelet ratio index, fibrosis-4, paediatric NAFLD fibrosis index and paediatric NAFLD fibrosis score...
September 25, 2017: Journal of Paediatrics and Child Health
Savinda Liyanagedera, Robert Patrick Williams, Silvio Veraldi, Valerio Nobili, Jake P Mann
Non-alcoholic fatty liver disease (NAFLD) represents a spectrum, including 'simple' steatosis, non-alcoholic steatohepatitis (NASH), and fibrosis. Increasing prevalence of NAFLD has followed the international rise in obesity and lifestyle modification is the mainstay therapy for children. To date, pharmacological trials have had varying efficacy but a large number of new agents are in early phase trials for adults. Areas covered: This review explores the effect of current and potential future paediatric NAFLD treatments in terms of histological and biochemical endpoints...
November 2017: Expert Review of Clinical Pharmacology
Valerio Nobili, Anna Alisi, Antonella Mosca, Claudia Della Corte, Silvio Veraldi, Rita De Vito, Cristiano De Stefanis, Valentina D'Oria, Joerg Jahnel, Evelyn Zohrer, Eleonora Scorletti, Christopher D Byrne
BACKGROUND & AIMS: Treatment with the farnesoid X receptor (FXR) agonist obeticholic acid is ineffective in some patients with non-alcoholic steatohepatitis (NASH) but the explanation is uncertain. We investigated hepatic FXR expression, and measurements of fibroblast growth factor 19 (FGF19) and bile acids (BAs) in children with NAFLD to investigate relationships with NASH. METHODS: 33 children with NAFLD who underwent diagnostic liver biopsy were studied. Hepatic FXR protein levels and circulating FGF19 concentrations were compared with those analysed in five control subjects with proven normal liver histology...
July 26, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
S Hsieh, B P Leaderer, A E Feldstein, N Santoro, L A McKay, S Caprio, R McConnell
INTRODUCTION: Traffic-related air pollution causes fatty liver, inflammation and fibrosis in animal models, but there have been few studies in humans. OBJECTIVES: To test the hypothesis that traffic-related air pollution causes non-alcoholic fatty liver disease (NAFLD) and increased markers for non-alcoholic steatohepatitis (NASH); and that NAFLD increases liver susceptibility to increased NASH risk. METHODS: Data collected prospectively from 74 overweight or obese children were obtained from the Yale Pediatric Obesity Clinic...
July 20, 2017: Pediatric Obesity
B G P Koot, V Nobili
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the industrialized world in children. Its high prevalence and important health risks make NAFLD highly suitable for screening. In practice, screening is widely, albeit not consistently, performed. AIM: To review the recommendations on screening for NAFLD in children. METHOD: Recommendations on screening were reviewed from major paediatric obesity guidelines and NAFLD guidelines...
May 25, 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
Evelyn Zöhrer, Anna Alisi, Jörg Jahnel, Antonella Mosca, Claudia Della Corte, Annalisa Crudele, Günter Fauler, Valerio Nobili
Nonalcoholic steatohepatitis (NASH), a progressive form of nonalcoholic fatty liver disease, is one of the most common hepatic diseases in children. We conducted a randomized controlled clinical trial on children with biopsy-proven NASH based on a combinatorial nutritional approach compared with placebo. Participants were assigned to lifestyle modification plus placebo or lifestyle modification plus a mix containing docosahexaenoic acid, choline, and vitamin E (DHA-CHO-VE). Forty children and adolescents participated in the entire trial...
May 16, 2017: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Philippa S Gibson, Sarah Lang, Anil Dhawan, Emer Fitzpatrick, Michelle L Blumfield, Helen Truby, Kathryn H Hart, J Bernadette Moore
OBJECTIVES: To evaluate efficacy of nutrition and physical activity interventions in the clinical management of paediatric non-alcoholic fatty liver disease (NAFLD). The prevalence of paediatric NAFLD continues to rise alongside childhood obesity. Weight loss through lifestyle modification is currently first-line treatment, although supplementation of specific dietary components may be beneficial. METHODS: Medline, CINAHL, EMBASE, Scopus and Cochrane Libraries were systematically searched to identify randomised controlled trials (RCTs) assessing nutritional and physical activity interventions...
May 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
M D Thompson, M J Cismowski, M Serpico, A Pusateri, D R Brigstock
As childhood obesity increases, it is becoming important to understand the complications of obesity in children and develop novel biomarkers. Evidence indicates that microRNAs (miRNA) are dys-regulated in obesity and may serve as sensitive and specific circulating biomarkers. Non-alcoholic fatty liver disease (NAFLD) is a complication of obesity that ultimately requires a liver biopsy to determine disease severity. While studies have been conducted in adults, no study to date has examined circulating miRNAs in children with obesity and NAFLD...
August 2017: Clinical Obesity
Sebastian Kummer, Dirk Klee, Gerald Kircheis, Michael Friedt, Joerg Schaper, Dieter Häussinger, Ertan Mayatepek, Thomas Meissner
The liver is intensely involved in glucose metabolism and is thereby closely related to diabetes pathophysiology. Adult patients with type 1 diabetes mellitus (DM) are at an increased risk for non-alcoholic fatty liver disease (NAFLD). Here, we studied the prevalence of NAFLD in a cohort of children and adolescents with type 1 DM in a tertiary care paediatric diabetes centre in Germany. We screened 93 children and adolescents with type 1 DM using ultrasound, laboratory investigations, and liver stiffness measurements (Fibroscan® [FS] and acoustic radiation force imaging [ARFI])...
April 2017: European Journal of Pediatrics
N Y Yu, T Wolfson, M S Middleton, G Hamilton, A Gamst, J E Angeles, J B Schwimmer, C B Sirlin
AIM: To investigate the relationship between bone marrow fat content and hepatic fat content in children with known or suspected non-alcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS: This was an institutional review board-approved, Health Insurance Portability and Accountability Act (HIPAA)-compliant, cross-sectional, prospective analysis of data collected between October 2010 to March 2013 in 125 children with known or suspected NAFLD. Written informed consent was obtained for same-day research magnetic resonance imaging (MRI) of the lumbar spine, liver, and abdominal adiposity...
May 2017: Clinical Radiology
Jake P Mann, Ariel E Feldstein, Valerio Nobili
PURPOSE OF REVIEW: To describe the recent advances in our understanding of fatty acids and lipids in paediatric nonalcoholic fatty liver disease (NAFLD) and their future implications. RECENT FINDINGS: Data have been accumulated to suggest that ceramides are the main drivers of hepatic insulin resistance in NAFLD, and inhibition of ceramide synthesis improves histology in mice.Saturated fatty acids formed by de novo lipogenesis generate increased lipotoxicity compared with dietary-derived saturated fatty acids...
March 2017: Current Opinion in Clinical Nutrition and Metabolic Care
Shuang Liang, Xiangdeng Cheng, Yanyan Hu, Ruxin Song, Guimei Li
AIM: Few studies have investigated the relationship between paediatric nonalcoholic fatty liver disease (NAFLD) and insulin-like growth factor 1 (IGF-1). This study, carried out from July 2013 to September 2015, aimed to fill the gap and added metabolic parameters to the analysis. METHODS: This was a cross-sectional study of 168 obese children and adolescents (84% male), divided into two groups based on the presence (n = 90) or absence (n = 78) of NAFLD. All participants underwent clinical examinations, anthropometric and laboratory examinations and liver ultrasonography...
February 2017: Acta Paediatrica
S Oliveira, A K Samba, A J Towbin, A Gupta, J I Geller, J D Nathan, R Kohli
Hepatocellular adenomas (HCA) are benign tumours with potential for malignant transformation with no recommendations regarding management in the paediatric population. We report a case of an inflammatory adenoma with β-catenin activated pathway in an obese, paediatric patient with nonalcoholic steatohepatitis (NASH). CASE REPORT: An 11-year-old female presented with a microlobulated liver lesion measuring >5 cm in magnetic resonance imaging (MRI) with inflammatory adenoma with β-catenin activated pathology arising in a background of NASH, nonalcoholic fatty liver disease (NAFLD) activity score 5/8...
January 2018: Pediatric Obesity
Antonella Mosca, Claudia Della Corte, Maria Rita Sartorelli, Francesca Ferretti, Francesco Nicita, Andrea Vania, Valerio Nobili
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and adolescents, due to the increased worldwide incidence of obesity among children. It is now clear enough that of diet high in carbohydrates and simple sugars are associated with hepatic steatosis and non-alcoholic steatohepatitis (NASH). Several studies have shown that an increased consumption of simple sugars is also positively associated with overweight and obesity, and related co-morbidities, such as type 2 diabetes, metabolic syndrome and NAFLD...
December 2016: Eating and Weight Disorders: EWD
Judith Aron-Wisnewsky, Karine Clement, Jean-Louis Pépin
Obstructive sleep apnea (OSA) and more importantly its hallmark, chronic intermittent hypoxia (CIH), are established factors in the pathogenesis and exacerbation of nonalcoholic fatty liver disease (NAFLD). This has been clearly demonstrated in rodent models exposed to intermittent hypoxia, and strong evidence now also exists in both paediatric and adult human populations. OSA and CIH induce insulin-resistance and dyslipidemia which are involved in NAFLD physiopathogenesis. CIH increases the expression of the hypoxia inducible transcription factor HIF1α and that of downstream genes involved in lipogenesis, thereby increasing β-oxidation and consequently exacerbating liver oxidative stress...
August 2016: Metabolism: Clinical and Experimental
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