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NAFLD in children

R Jin, A Krasinskas, N-A Le, J V Konomi, J Holzberg, R Romero, M B Vos
BACKGROUND: Plasminogen activator inhibitor-1 (PAI-1) is the primary inhibitor of the endogenous fibrinolytic system and is known to be increased in obesity, insulin resistance and non-alcoholic fatty liver disease (NAFLD). We previously demonstrated that PAI-1 levels were closely related to the amount of hepatic steatosis in children. OBJECTIVES: The aim of this study was to characterize plasma PAI-1 in relationship to severity of inflammation and fibrosis, as well as to plasma lipids in children with NAFLD...
October 20, 2016: Pediatric Obesity
Xiaopeng Zhu, Hua Bian, Xin Gao
Nonalcoholic fatty liver disease (NAFLD) is a globally observed metabolic disease with high prevalence both in adults and children. However, there is no efficient medication available yet. Increased evidence indicates that berberine (BBR), a natural plant product, has beneficial effects on NAFLD, though the mechanisms are not completely known. In this review, we briefly summarize the pathogenesis of NAFLD and factors that influence the progression of NAFLD, and focus on the potential mechanisms of BBR in the treatment of NAFLD...
October 14, 2016: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Fatemeh Famouri, Zainab Shariat, Mahin Hashemipour, Mojtaba Keikha, Roya Kelishadi
OBJECTIVES: This trial aims to evaluate the effects of some probiotics on sonographic and biochemical non-alcoholic fatty liver disease (NAFLD). METHODS: This randomized triple-blind trial was conducted among 64 obese children with sonographic NAFLD. They were randomly allocated to receive probiotic capsule (containing Lactobacillus acidophilus ATCC B3208, 3 × 10 colony forming units, CFU; Bifidobacterium lactis DSMZ 32269, 6 × 10 CFU; B bifidum ATCC SD6576, 2 × 10 CFU; L rhamnosus DSMZ 21690, 2 × 10 CFU) or placebo for 12 weeks...
October 13, 2016: Journal of Pediatric Gastroenterology and Nutrition
Sunil V Pawar, Vinay G Zanwar, Ajay S Choksey, Ashok R Mohite, Samit S Jain, Ravindra G Surude, Qais Q Contractor, Pravin M Rathi, Ravi U Verma, Premlata K Varthakavi
:  Background and rationale. Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease in western countries. Its prevalence in Indian subcontinent is not well studied. MATERIAL AND METHODS: In a school based cross sectional study we have screened overweight and obese children in the age group of 11 to 15 years for NAFLD. Ultrasonography, elevated serum transaminases, fibroscan were used for defining NAFLD. Dietary habits, blood pressure, serum lipid profile, blood counts and insulin resistance were recorded...
November 2016: Annals of Hepatology
Min-Su Oh, Sorina Kim, Joon-Hyuck Jang, Jong Yoon Park, Hyun-Sik Kang, Mu Sook Lee, Ki Soo Kang
PURPOSE: To analyze the associations among the degrees of nonalcoholic fatty liver disease (NAFLD) by ultrasonography and metabolic syndrome, degrees of obesity in children, and degrees of parental obesity. METHODS: A total of 198 children with obesity who visited a pediatric obesity clinic were prospectively enrolled in this study. The severity of NAFLD based on ultrasonography was classified into no, mild, moderate, or severe NAFLD group. The degree of obesity based on the percentage over standard weight for height per sex was classified into mild, moderate, or severe...
September 2016: Pediatric Gastroenterology, Hepatology & Nutrition
Kyoung Ah Kwon, Peter Chun, Jae Hong Park
PURPOSE: This study aimed to investigate the clinical significance of serum alanine aminotransferase (ALT) levels in children with nonalcoholic fatty liver disease (NAFLD) and the effect of lifestyle intervention on NAFLD. METHODS: The clinical data of 86 children diagnosed with NAFLD were reviewed retrospectively. Forty-six patients belonged to the elevated ALT group and 40 to the normal ALT group. The clinical parameters of patients with NAFLD were also compared based on the status of ALT levels after lifestyle intervention...
September 2016: Korean Journal of Pediatrics
Maria Grazia Clemente, Claudia Mandato, Marco Poeta, Pietro Vajro
Non-alcoholic fatty liver disease (NAFLD) in children is becoming a major health concern. A "multiple-hit" pathogenetic model has been suggested to explain the progressive liver damage that occurs among children with NAFLD. In addition to the accumulation of fat in the liver, insulin resistance (IR) and oxidative stress due to genetic/epigenetic background, unfavorable lifestyles, gut microbiota and gut-liver axis dysfunction, and perturbations of trace element homeostasis have been shown to be critical for disease progression and the development of more severe inflammatory and fibrotic stages [non-alcoholic steatohepatitis (NASH)]...
September 28, 2016: World Journal of Gastroenterology: WJG
Ryan W Himes, Sarah E Barlow, Kevin Bove, Norma M Quintanilla, Rachel Sheridan, Rohit Kohli
Lysosomal acid lipase deficiency (LAL-D) is a classic lysosomal storage disorder characterized by accumulation of cholesteryl ester and triglyceride. Although it is associated with progressive liver injury, fibrosis, and end-stage liver disease in children and adolescents, LAL-D frequently presents with nonspecific signs that overlap substantially with other, more common, chronic conditions like nonalcoholic fatty liver disease (NAFLD), metabolic syndrome, and certain inherited dyslipidemias. We present 2 children with NAFLD who achieved clinically significant weight reduction through healthy eating and exercise, but who failed to have the anticipated improvements in aminotransferases and γ-glutamyl transferase...
September 13, 2016: Pediatrics
Donghee Kim, W Ray Kim
Nonalcoholic fatty liver disease (NAFLD) refers to a group of conditions characterized by hepatic steatosis in the absence of significant alcohol consumption. NAFLD is commonly seen in patients with metabolic abnormalities associated with obesity, such as type II diabetes, dyslipidemia, and metabolic syndrome. Evidently, however, not all obese subjects develop NAFLD and, more importantly, NAFLD can be found in non-obese individuals. While NAFLD occurring in non-obese subjects has been reported in children and adults of all ethnicities, it appears to be recognized more frequently in Asians, even when strict ethnicity-specific body mass index criteria are used to define obesity...
August 28, 2016: Clinical Gastroenterology and Hepatology
Jeffrey B Schwimmer, Joel E Lavine, Laura A Wilson, Brent A Neuschwander-Tetri, Stavra A Xanthakos, Rohit Kohli, Sarah E Barlow, Miriam B Vos, Saul J Karpen, Jean P Molleston, Peter F Whitington, Philip Rosenthal, Ajay K Jain, Karen F Murray, Elizabeth M Brunt, David E Kleiner, Mark L Van Natta, Jeanne M Clark, James Tonascia, Edward Doo
BACKGROUND & AIMS: No treatment for nonalcoholic fatty liver disease (NAFLD) has been approved by regulatory agencies. We performed a randomized controlled trial to determine whether 52 weeks of cysteamine bitartrate delayed release (CBDR) reduces the severity of liver disease in children with NAFLD. METHODS: We performed a double-masked trial of 169 children with NAFLD Activity Scores ≥ 4 at 10 centers. From June 2012 to January 2014, the patients were randomly assigned to receive CBDR or placebo twice daily (300 mg for ≤65 kg, 375 mg for >65-80 kg, 450 mg for >80 kg) for 52 weeks...
August 25, 2016: Gastroenterology
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...
August 26, 2016: Eating and Weight Disorders: EWD
Amal Mohamed Ahmed, Maha Abdel Ghany, Gehan Lotfy Abdel Hakeem, Aya Kamal, Rania Khattab, Asmaa Abdalla, Laila El Morsi Abou El Fotoh, Abdel Azeem El Mazary, Madiha Abdalla Sayed, Ashraf Mohamed Abdel Fadil
BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is one of the health problems with great burden on the liver that may end with liver cirrhosis and hepatocellular carcinoma. The aim of this work was to assess serum vitamin D level in nonalcoholic fatty liver disease children. METHODS: This cross sectional case control study involved 47 patients with nonalcoholic fatty liver disease selected while recruiting the pediatric hepatology clinics. Their ages ranged from 5-15 years and were compared with 23 healthy age and sex matched children...
2016: Nutrition & Metabolism
Giorgio Bedogni, Andrea Mari, Alessandra De Col, Nicoletta Marazzi, Claudio Tiribelli, Melania Manco, Alessandro Sartorio
BACKGROUND: No study so far has evaluated the relationship between insulin secretion (ISEC) and insulin sensitivity (ISEN) in pediatric nonalcoholic fatty liver disease (NAFLD). We evaluated the relationship between ISEC and ISEN in young obese patients with and without NAFLD. METHODS: We matched 401 NAFLD(+) and 595 NAFLD(-) children by sex (same), age (≤1 year), pubertal status (same), and body mass index (BMI; ≤0.05 standard deviation scores) using coarsened exact matching...
August 19, 2016: Childhood Obesity
Kimberly P Newton, Jiayi Hou, Nancy A Crimmins, Joel E Lavine, Sarah E Barlow, Stavra A Xanthakos, Jonathan Africa, Cynthia Behling, Michele Donithan, Jeanne M Clark, Jeffrey B Schwimmer
Importance: Nonalcoholic fatty liver disease (NAFLD) is a major chronic liver disease in children in the United States and is associated with insulin resistance. In adults, NAFLD is also associated with type 2 diabetes. To our knowledge, the prevalence of type 2 diabetes in children with NAFLD is unknown. Objective: To determine the prevalence of type 2 diabetes and prediabetes in children with NAFLD and assess type 2 diabetes and prediabetes as risk factors for nonalcoholic steatohepatitis (NASH)...
October 3, 2016: JAMA Pediatrics
Lucia Pacifico, Enea Bonci, Gian Marco Andreoli, Michele Di Martino, Alessia Gallozzi, Ester De Luca, Claudio Chiesa
The association between nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease has attracted interest and attention over recent years. However, no data are available in children. We determined whether children with NAFLD show signs of renal functional alterations, as determined by estimated glomerular filtration rate (eGFR) and urinary albumin excretion. We studied 596 children with overweight/obesity, 268 with NAFLD (hepatic fat fraction ≥5% on magnetic resonance imaging) and 328 without NAFLD, and 130 healthy normal-weight controls...
2016: International Journal of Molecular Sciences
L F Gu, Y Q Wang, J G Fan
Nonalcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in developed and developing countries. NAFLD is considered to be the manifestation of metabolic syndrome in the liver and an important risk factor for cardiovascular diseases as well. Studies have shown that NAFLD patients have significantly increased the prevalence rates of the diseases including ischemic heart disease and heart failure. Therefore, whether the changes in cardiac structure and impaired cardiac function occur before the development of organic heart diseases in NAFLD patients has attracted scholars' attention...
June 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Jae Hwa Jung, Mo Kyung Jung, Ki Eun Kim, Ah Reum Kwon, Hyun Wook Chae, Choon Sik Yoon, Ho Seong Kim, Duk-Hee Kim
PURPOSE: Abdominal obesity is a fundamental factor underlying the development of metabolic syndrome. Because of radiation exposure and cost, computed tomography or dual-energy X-ray absorptiometry to evaluate abdominal adiposity are not appropriate in children. Authors evaluated whether ultrasound results could be an indicator of insulin resistance and nonalcoholic fatty liver disease (NAFLD). METHODS: We enrolled 73 subjects (aged 6-16 years) who were evaluated abdominal adiposity by ultrasound...
June 2016: Annals of Pediatric Endocrinology & Metabolism
Rasha Tarif Hamza, Alaa Youssef Ahmed, Doaa Gamal Rezk, Amira Ibrahim Hamed
BACKGROUND: Excessive use of fructose has been incriminated as a risk factor for hepatic steatosis. Procollagen type III N-terminal peptide (P3NP) is a marker for steatohepatitis. Thus, we aimed to assess fructose intake in obese children and its relation to nonalcoholic fatty liver disease (NAFLD) and P3NP. METHODS: Fifty-five obese children were compared to 30 controls. All were subjected to dietary fructose and anthropometric assessment, fasting blood sugar (FBS), fasting insulin (FI) and homeostasis model assessment of insulin resistance (HOMA-IR), lipid profile, uric acid, alanine aminotransferase (ALT), P3NP and abdominal ultrasound...
July 21, 2016: Journal of Pediatric Endocrinology & Metabolism: JPEM
Yu-Cheng Lin, Pi-Feng Chang, Hsueh-Fang Lin, Kevin Liu, Mei-Hwei Chang, Yen-Hsuan Ni
BACKGROUND & AIMS: Autophagy has been shown to be crucial in the regulation of the intracellular lipid stores in hepatocytes. We hypothesize that immunity-related GTPase family M (IRGM) gene (an autophagy-related gene) variants confer the susceptibility to nonalcoholic fatty liver disease (NAFLD) development. METHODS: 832 obese children and adolescents aged 6-18 years were recruited. NAFLD was determined by liver ultrasonography. We genotyped PNPLA3 rs738409, GCKR rs780094, TM6SF2rs58542926, sixIRGM single nucleotide polymorphisms (rs13361189, rs9637876, rs72553867, rs10065172, rs1000113, and rs11747270)...
July 11, 2016: Journal of Hepatology
Inez Martincevic, Marialena Mouzaki
BACKGROUND: The mainstay of treatment for pediatric nonalcoholic fatty liver disease (NAFLD) is lifestyle modification, which includes dietary changes that lead to slow but sustained weight loss or weight stabilization in growing children. Accurate estimation of energy requirements is necessary to achieve this goal. The objective of this study was to assess the accuracy of the most commonly used equations in predicting the resting energy expenditure (REE) of children with NAFLD. METHODS: This was a retrospective study performed in a single institution...
July 12, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
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