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Pediatric fatty liver

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https://www.readbyqxmd.com/read/28337087/medication-dosage-in-overweight-and-obese-children
#1
Kelly L Matson, Evan R Horton, Amanda C Capino
Approximately 31.8% of U.S. children ages 2 to 19 years are considered overweight or obese. This creates significant challenges to dosing medications that are primarily weight based (mg/kg) and in predicting pharmacokinetics parameters in pediatric patients. Obese individuals generally have a larger volume of distribution for lipophilic medications. Conversely, the Vd of hydrophilic medications may be increased or decreased due to increased lean body mass, blood volume, and decrease percentage of total body water...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28333768/management-of-pediatric-non-alcoholic-fatty-liver-disease-by-academic-hepatologists-in-canada-a-nationwide-survey
#2
Marialena Mouzaki, Simon C Ling, Richard A Schreiber, Binita M Kamath
BACKGROUND: The literature on the optimal clinical management of pediatric patients with non-alcoholic fatty liver disease (NAFLD) is limited. The objective of this study was to identify discrepancies in the care provided to patients with NAFLD by hepatologists practicing in academic centers across Canada. METHODS: A nationwide survey was distributed electronically to all pediatric hepatologists practicing in university-affiliated hospitals using the infrastructure of the Canadian Pediatric Hepatology Research Group...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28333693/pediatric-intestinal-failure-associated-liver-disease
#3
Cathleen M Courtney, Brad W Warner
PURPOSE OF REVIEW: The goal of this review is to provide updates on the definition, pathophysiology, treatment, and prevention of intestinal failure-associated liver disease (IFALD) that are relevant to care of pediatric patients. RECENT FINDINGS: Current literature emphasizes the multifactorial nature of IFALD. The pathogenesis is still largely unknown; however, molecular pathways have been identified. Key to these pathways are proinflammatory cytokines involved in hepatic inflammation and bile acids synthesis such as Toll-like receptor 4 and farnesoid X receptor, respectively...
March 22, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28333140/metabolic-and-molecular-insights-into-an-essential-role-of-nicotinamide-phosphoribosyltransferase
#4
Li Q Zhang, Leon Van Haandel, Min Xiong, Peixin Huang, Daniel P Heruth, Charlie Bi, Roger Gaedigk, Xun Jiang, Ding-You Li, Gerald Wyckoff, Dmitry N Grigoryev, Li Gao, Linheng Li, Min Wu, J Steven Leeder, Shui Qing Ye
Nicotinamide phosphoribosyltransferase (NAMPT) is a pleiotropic protein implicated in the pathogenesis of acute respiratory distress syndrome, aging, cancer, coronary heart diseases, diabetes, nonalcoholic fatty liver disease, obesity, rheumatoid arthritis, and sepsis. However, the underlying molecular mechanisms of NAMPT in these physiological and pathological processes are not fully understood. Here, we provide experimental evidence that a Nampt gene homozygous knockout (Nampt(-/-)) resulted in lethality at an early stage of mouse embryonic development and death within 5-10 days in adult mice accompanied by a 25...
March 23, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28324110/effects-of-metreleptin-in-pediatric-patients-with-lipodystrophy
#5
Rebecca J Brown, Cristina Adelia Meehan, Elaine Cochran, Kristina I Rother, David E Kleiner, Mary Walter, Phillip Gorden
Context: Lipodystrophy syndromes are rare disorders of deficient adipose tissue. Metreleptin, a human analog of leptin, improved metabolic abnormalities in mixed cohorts of leptin-deficient children and adults with lipodystrophy. Objective: Determine effects of metreleptin on diabetes, hyperlipidemia, non-alcoholic fatty liver disease (NAFLD), growth, and puberty in leptin-deficient pediatric patients with lipodystrophy. Design: Prospective, single-arm, open-label studies with continuous enrollment since 2000...
January 23, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28322576/the-effects-of-exercise-on-abdominal-fat-and-liver-enzymes-in-pediatric-obesity-a-systematic-review-and-meta-analysis
#6
Katherine González-Ruiz, Robinson Ramírez-Vélez, Jorge Enrique Correa-Bautista, Mark D Peterson, Antonio García-Hermoso
BACKGROUND: Despite the prevalence of obesity and the multiple position stands promoting exercise for the treatment of obesity and hepatic function, a meta-analytic approach has not previously been used to examine the effects in the pediatric population. The aim of the study was to determine the effectiveness of exercise interventions on abdominal fat, liver enzymes, and intrahepatic fat in overweight and obese youth. MATERIALS AND METHODS: A computerized search was made using three databases...
March 21, 2017: Childhood Obesity
https://www.readbyqxmd.com/read/28319602/low-hepatic-tissue-copper-in-pediatric-non-alcoholic-fatty-liver-disease
#7
Michael Mendoza, Shelley Caltharp, Ming Song, Lindsay Collin, Juna V Konomi, Craig J McClain, Miriam B Vos
OBJECTIVE: Animal models and studies in adults have demonstrated that copper restriction increases severity of liver injury in non-alcoholic fatty liver disease (NAFLD). This has not been studied in children. We aimed to determine if lower tissue copper is associated with increased NAFLD severity in children. METHODS: This was a retrospective study of pediatric patients who had a liver biopsy including a hepatic copper quantitation. The primary outcome compared hepatic copper concentration in NAFLD versus non-NAFLD...
March 17, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28318950/cholesteryl-ester-storage-disease-an-underdiagnosed-cause-of-cirrhosis-in-adults
#8
REVIEW
Mamta Pant, Kiyoko Oshima
Cholesteryl Ester Storage Disease (CESD), is a rare multisystem autosomal recessive disorder and belongs to the broad family of lysosomal storage disorders. It can present anytime from infancy and childhood to even adulthood. The clinical manifestations are generally severe in infants and with milder forms in adults. One of the prominent sites of involvement is liver. Due to low awareness of this condition among physicians including surgical pathologists, majority of the liver biopsies, especially from the adults are often misdiagnosed as non-alcoholic fatty liver disease/non-alcoholic steatohepatitis or cryptogenic cirrhosis...
February 9, 2017: Annals of Diagnostic Pathology
https://www.readbyqxmd.com/read/28298942/liver-acoustic-radiation-force-impulse-arfi-in-childhood-obesity-comparison-and-correlation-with-biochemical-markers
#9
COMPARATIVE STUDY
Rajeev Kamble, Kushaljit S Sodhi, Babu R Thapa, Akshay K Saxena, Anmol Bhatia, Devi Dayal, Niranjan Khandelwal
PURPOSE: To compare and correlate the diagnostic efficiency of acoustic radiation force impulse (ARFI) elastography with biochemical markers for assessing hepatic changes in overweight and obese children. METHODS: This prospective study was approved by the institutional ethics committee. It included 54 overweight and obese children and 50 normal children (as a control group) in the age range 5-18 years. For all children, we performed grayscale ultrasonography to diagnose fatty liver, ARFI elastography to measure liver stiffness, and biochemical evaluation for aspartate aminotransferase (AST), alanine aminotransferase (ALT), and serum triglyceride (TG) levels...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28286193/in-children-with-nonalcoholic-fatty-liver-disease-zone-1-steatosis-is-associated-with-advanced-fibrosis
#10
Jonathan A Africa, Cynthia A Behling, Elizabeth M Brunt, Nan Zhang, Yunjun Luo, Alan Wells, Jiayi Hou, Patricia H Belt, Rohit Kohil, Joel E Lavine, Jean P Molleston, Kimberly P Newton, Peter F Whitington, Jeffrey B Schwimmer
BACKGROUND & AIMS: Focal zone 1 steatosis, although rare in adults with nonalcoholic fatty liver disease (NAFLD), does occur in children with NAFLD. We investigated whether focal zone 1 steatosis and focal zone 3 steatosis are distinct subphenotypes of pediatric NAFLD. We aimed to determine associations between the zonality of steatosis and demographic, clinical, and histologic features in children with NAFLD. METHODS: We performed a cross-sectional study of baseline data from 813 children (age less than 18 years; mean age, 12...
March 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28267037/intravenous-lipid-emulsions-in-pediatric-patients-with-intestinal-failure
#11
Olivier Goulet, Cécile Lambe
The incidence of cholestatic liver disease (CLD) in pediatric patients suffering intestinal failure (IF) is not well established. Due to persistent portal inflammation, about 20% of these patients will progress to end-stage intestinal failure associated liver disease (IFALD) leading to liver transplant or death. PURPOSE OF REVIEW: Premature babies as well as infants with short bowel syndrome (SBS) and repeated sepsis (catheter or small intestinal bacterial overgrowth related) are at risk of developing CLD...
April 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28242319/white-paper-aga-power-practice-guide-on-obesity-and%C3%A2-weight-management-education-and-resources
#12
REVIEW
Andres Acosta, Sarah Streett, Mathew D Kroh, Lawrence J Cheskin, Katherine H Saunders, Marina Kurian, Marsha Schofield, Sarah E Barlow, Louis Aronne
The epidemic of obesity continues at alarming rates, with a high burden to our economy and society. The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity. Because gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, gastroenterologists have an opportunity to address obesity and provide an effective therapy early...
February 24, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28230607/effects-of-probiotics-on-nonalcoholic-fatty-liver-disease-in-obese-children-and-adolescents
#13
Fatemeh Famouri, Zainab Shariat, Mahin Hashemipour, Mojtaba Keikha, Roya Kelishadi
OBJECTIVES: This study aims to evaluate the effects of some probiotics on sonographic and biochemical nonalcoholic 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; Bifidobacterium bifidum ATCC SD6576, 2 × 10 CFU; Lactobacillus rhamnosus DSMZ 21690, 2 × 10 CFU) or placebo for 12 weeks...
March 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28225568/liver-histology-and-diffusion-weighted-mri-in-children-with-nonalcoholic-fatty-liver-disease-a-magnet-study
#14
Paul Manning, Paul Murphy, Kang Wang, Jonathan Hooker, Tanya Wolfson, Michael S Middleton, Kimberly P Newton, Cynthia Behling, Hannah I Awai, Janis Durelle, Melissa N Paiz, Jorge E Angeles, Diana De La Pena, J Allen McCutchan, Jeffrey B Schwimmer, Claude B Sirlin
PURPOSE: To determine potential associations between histologic features of pediatric nonalcoholic fatty liver disease (NAFLD) and estimated quantitative magnetic resonance diffusion-weighted imaging (DWI) parameters. MATERIALS AND METHODS: This prospective, cross-sectional study was performed as part of the Magnetic Resonance Assessment Guiding NAFLD Evaluation and Treatment (MAGNET) ancillary study to the Nonalcoholic Steatohepatitis Clinical Research Network (NASH CRN)...
February 22, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28203453/association-of-osteoprotegerin-with-obesity-insulin-resistance-and-non-alcoholic-fatty-liver-disease-in-children
#15
Meltem Erol, Ozlem Bostan Gayret, Hikmet Tekin Nacaroglu, Ozgul Yigit, Oguzhan Zengi, Mehmet Salih Akkurt, Mehmet Tasdemir
BACKGROUND: Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily. Reduced OPG levels are related to obesity, insulin resistance, and non-alcoholic fatty liver disease (NAFLD). OBJECTIVES: The aim of this study was to evaluate the relationship between OPG levels, obesity, insulin resistance, and NAFLD in pediatric patients. METHODS: This was a prospective, cross-sectional, controlled study that was conducted in the department of pediatrics at Bagcilar training and research hospital in Istanbul, Turkey, between April and August 2015...
November 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28192105/adolescent-obesity-and-insulin-resistance-roles-of-ectopic-fat-accumulation-and-adipose-inflammation
#16
Sonia Caprio, Rachel Perry, Romy Kursawe
As a consequence of the global rise in the prevalence of Adolescent Obesity, an unprecedented phenomenon of Type 2 Diabetes (T2D) has emerged in pediatrics. At the heart of T2D development lies a key metabolic derangement: Insulin Resistance (IR) . Despite the widespread occurrence of IR affecting an unmeasurable number of youths worldwide, its pathogenesis remains elusive. IR in obese youth is a complex phenomenon that defies explanation by a single pathway. In this review we first describe recent data on the prevalence, severity, and racial/ethnic differences in Pediatric Obesity...
February 9, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28162008/clinical-implications-of-understanding-the-association-between-oxidative-stress-and-pediatric-nafld
#17
Jake P Mann, Massimiliano Raponi, Valerio Nobili
Oxidative stress is central to the pathogenesis of non-alcoholic steatohepatitis. The reactive oxygen species (ROS) that characterise oxidative stress are generated in several cellular sites and their production is influence by multi-organ interactions. Areas covered: Mitochondrial dysfunction is the main source of ROS in fatty liver and is closely related to endoplasmic reticulum stress. Both are caused by lipotoxicity and together these three factors form a cycle of progressive organelle damage, resulting in sterile inflammation and apoptosis...
April 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28160250/thiopurines-and-methotrexate-use-in-ibd-patients-in-a-biologic-era
#18
REVIEW
Gerassimos J Mantzaris
Although we have been living in the era of biologic therapy for several decades, the use of immunomodulators (primarily thiopurines [azathioprine and mercaptopurine] and less so methotrexate) still remains an important component of the inflammatory bowel disease (IBD) pharmaceutical arsenal. Thiopurines as monotherapy exert corticosteroid-sparing effects and can maintain long-term remission in a considerable proportion of patients who have frequent relapses and are or have become mesalazine and/or corticosteroid intolerant or refractory...
March 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28144387/from-the-liver-to-the-heart-cardiac-dysfunction-in-obese-children-with-non-alcoholic-fatty-liver-disease
#19
EDITORIAL
Anna Di Sessa, Giuseppina Rosaria Umano, Emanuele Miraglia Del Giudice, Nicola Santoro
In the last decades the prevalence of non-alcoholic fatty liver disease (NAFLD) has increased as a consequence of the childhood obesity world epidemic. The liver damage occurring in NAFLD ranges from simple steatosis to steatohepatitis, fibrosis and cirrhosis. Recent findings reported that fatty liver disease is related to early atherosclerosis and cardiac dysfunction even in the pediatric population. Moreover, some authors have shown an association between liver steatosis and cardiac abnormalities, including rise in left ventricular mass, systolic and diastolic dysfunction and epicardial adipose tissue thickness...
January 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28107283/naspghan-clinical-practice-guideline-for-the-diagnosis-and-treatment-of-nonalcoholic-fatty-liver-disease-in-children-recommendations-from-the-expert-committee-on-nafld-econ-and-the-north-american-society-of-pediatric-gastroenterology-hepatology-and-nutrition
#20
Miriam B Vos, Stephanie H Abrams, Sarah E Barlow, Sonia Caprio, Stephen R Daniels, Rohit Kohli, Marialena Mouzaki, Pushpa Sathya, Jeffrey B Schwimmer, Shikha S Sundaram, Stavra A Xanthakos
Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent chronic liver disease that occurs in the setting of insulin resistance and increased adiposity. It has rapidly evolved into the most common liver disease seen in the pediatric population and is a management challenge for general pediatric practitioners, subspecialists, and for health systems. In this guideline, the expert committee on NAFLD reviewed and summarized the available literature, formulating recommendations to guide screening and clinical care of children with NAFLD...
February 2017: Journal of Pediatric Gastroenterology and Nutrition
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