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de Cuevillas B, Lubrecht J, Navas-Carretero S, Vreugdenhil A, Martinez JA. Sleep duration is associated with liver steatosis in children depending on body adiposity. Eur J Pediatr 2024; 183:779-789. [PMID: 38001309 PMCID: PMC10912132 DOI: 10.1007/s00431-023-05332-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023]
Abstract
Sleep is a factor associated with overweight/obesity risk, wherein interactions with fatty liver should be ascertained. The aim of this cross-sectional study was to analyze the possible relationships of sleep with liver health and whether this interplay is related to body adiposity distribution in children and adolescents. Anthropometric, clinical, and biochemical measurements were performed in children and adolescents (2-18 years old) with overweight/obesity (n = 854). Body fat distribution was clinically assessed, and several hepatic markers, including hepatic steatosis index, were calculated. Sleep time mediation (hours/day) in the relationship between the hepatic steatosis index and body fat distribution was investigated. Differences among diverse fatty liver disease scores were found between children with overweight or obesity (p < 0.05). Linear regression models showed associations between hepatic steatosis index and lifestyle markers (p < 0.001). Hepatic steatosis index was higher (about + 15%) in children with obesity compared to overweight (p < 0.001). Pear-shaped body fat distribution may seemingly play a more detrimental role on liver fat deposition. The association between sleep time and hepatic steatosis index was dependent on body mass index z-score. Post hoc analyses showed that 39% of the relationship of body fat distribution on hepatic steatosis index may be explained by sleep time. Conclusion: An association of sleep time in the relationship between body fat distribution and hepatic steatosis index was observed in children and adolescents with overweight/obesity, which can be relevant in the prevention and treatment of excessive adiposity between 2 and 18 years old. CLINICAL TRIAL NCT04805762. Import: As part of a healthy lifestyle, sleep duration might be a modifiable factor in the management of fatty liver disease in children. WHAT IS KNOWN • Sleep is an influential factor of overweight and obesity in children. • Excessive adiposity is associated with liver status in children and adolescents. WHAT IS NEW • Sleep time plays a role in the relationship between body fat distribution and liver disease. • Monitoring sleep pattern may be beneficial in the treatment of hepatic steatosis in children with excessive body weight.
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Affiliation(s)
- Begoña de Cuevillas
- Center for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain.
| | - Judith Lubrecht
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Santiago Navas-Carretero
- Center for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- IdiSNA, Health Research Institute of Navarra, Pamplona, Spain
| | - Anita Vreugdenhil
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - J Alfredo Martinez
- Center for Nutrition Research, Department of Nutrition, Food Sciences and Physiology, School of Pharmacy and Nutrition, University of Navarra, Irunlarrea 1, 31008, Pamplona, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Precision Nutrition Program, Research Institute On Food and Health Sciences IMDEA Food, CSIC-UAM, Madrid, Spain
- Centro de Medicina y Endocrinología, Universidad de Valladolid, Valladolid, Spain
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Zhang S, Wang L, Yu M, Guan W, Yuan J. Fat mass index as a screening tool for the assessment of non-alcoholic fatty liver disease. Sci Rep 2022; 12:20219. [PMID: 36418352 PMCID: PMC9684573 DOI: 10.1038/s41598-022-23729-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 11/04/2022] [Indexed: 11/25/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is replacing hepatitis B as the leading cause of chronic liver disease in China. The purpose of this study is to select good tools to identify NAFLD from the body composition, anthropometry and related routine clinical parameters. A total of 5076 steelworkers, aged 22-60 years, was included in this study. Body fat mass was measured via bioelectrical impedance analysis (BIA) and fat mass index (FMI) was derived. Ultrasonography method was used to detect hepatic steatosis. Random forest classifier and best subset regression were used to select useful parameters or models that can accurately identify NAFLD. Receiver operating characteristic (ROC) curves were used to describe and compare the performance of different diagnostic indicators and algorithms including fatty liver index (FLI) and hepatic steatosis index (HSI) in NAFLD screening. ROC analysis indicated that FMI can be used with high accuracy to identify heavy steatosis as determined by ultrasonography in male workers [area under the curve (AUC) 0.95, 95% CI 0.93-0.98, sensitivity 89.0%, specificity 91.4%]. The ability of single FMI to identify NAFLD is no less than that of combination panels, even better than the combination panel of HSI. The best subset regression model that including FMI, waist circumference, and serum levels of triglyceride and alanine aminotransferase has moderate accuracy in diagnosing overall NAFLD (AUC 0.83). FMI and the NAFLD best subset (BIC) score seem to be good tools to identify NAFLD in Chinese steelworkers.
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Affiliation(s)
- Shengkui Zhang
- grid.440734.00000 0001 0707 0296Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan, 063210 Hebei China ,grid.506261.60000 0001 0706 7839Department of Epidemiology and Health Statistics, School of Basic Medicine, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730 China
| | - Lihua Wang
- grid.440734.00000 0001 0707 0296Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan, 063210 Hebei China
| | - Miao Yu
- grid.440734.00000 0001 0707 0296Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan, 063210 Hebei China
| | - Weijun Guan
- grid.440734.00000 0001 0707 0296Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan, 063210 Hebei China
| | - Juxiang Yuan
- grid.440734.00000 0001 0707 0296Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, 21 Bohai Road, Caofeidian Xincheng, Tangshan, 063210 Hebei China
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Hatem R, Nawaz FA, Al-Sharif GA, Almoosa M, Kattan W, Tzivinikos C, Amirali EL, Albanna A. Nonalcoholic Fatty Liver Disease in Children and Adolescents Taking Atypical Antipsychotic Medications: Protocol for a Systematic Review and Meta-analysis. JMIR Res Protoc 2022; 11:e20168. [PMID: 35311689 PMCID: PMC8981001 DOI: 10.2196/20168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/14/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background Atypical antipsychotics (AAP) are commonly prescribed to children and adolescents and are associated with important adverse effects including weight gain and metabolic syndrome. Nonalcoholic fatty liver disease (NAFLD) is not only the most common pediatric liver disease but is also associated with serious complications including liver cirrhosis. Objective Given that NAFLD and AAP are associated with metabolic syndrome, we aim to comprehensively examine the association between AAP and NAFLD in children and adolescents. Methods We will conduct a systematic review of studies exploring NAFLD in subjects younger than 18 years on AAP published in English between 1950 and 2020 following the PRISMA (Preferred Reporting items for Systematic Reviews and Meta-Analysis) guidelines. Results A PRISMA flowchart will be used present the study results after comprehensively reviewing studies on NAFLD in children and adolescents taking AAP. The first and second systematic searches will be conducted during December 2021. The results are expected to be published in June 2022. Conclusions This research project will serve as a foundation for future studies and assist in devising interventions and reforming clinical guidelines for using AAP to ensure improved patient safety. International Registered Report Identifier (IRRID) PRR1-10.2196/20168
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Affiliation(s)
- Reem Hatem
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Faisal A Nawaz
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Ghadah A Al-Sharif
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Mohammad Almoosa
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Wid Kattan
- Division of Psychiatry, Department of Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - E Lila Amirali
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, QC, Canada
| | - Ammar Albanna
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates
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Alamri A, AlKhater SA. Evaluating the knowledge on microbiome and dysbiosis in allergic diseases among medical sciences students in Saudi Arabia. Clin Mol Allergy 2022; 20:2. [PMID: 35094706 PMCID: PMC8802525 DOI: 10.1186/s12948-022-00168-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Microbiome science deals with the development of diseases that are derived from the interaction between the host immune system and microbes. Microbiome disturbance or dysbiosis has been increasingly recognized as an important contributor to the pathogenesis of allergic diseases. Thus, this field is pivotal in the management of allergic disorders. Despite the increasing prevalence of allergic disorders in Saudi Arabia, medical students lack knowledge of microbiome science. Therefore, this study aimed to assess the level of knowledge of medical sciences students on the human microbiome, dysbiosis, and management of the impaired microbiome with a focus on allergic diseases and asthma. METHODS An online survey was designed, validated, and distributed to 100 final-year students and interns majoring in clinical nutrition, public health, and clinical laboratory sciences at a single university in Saudi Arabia. The study period was from November 2020 to January 2021. RESULTS The overall knowledge of the human microbiome was adequate among the participants, but their understanding of dysbiosis and management of the impaired microbiome was low to moderate. Knowledge of dysbiosis management was significantly higher in students majoring in clinical nutrition than in those majoring in public health and clinical laboratory sciences. CONCLUSIONS Collectively, this study provides the first evidence that knowledge of specific domains of microbiome science among a cohort of medical sciences students in Saudi Arabia is insufficient. Large-scale studies are warranted to confirm these observations at a national level, and specific curriculum modifications are necessary to improve the knowledge of future healthcare professionals about clinical applications of microbiome science.
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Affiliation(s)
- Aisha Alamri
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Suzan A AlKhater
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. .,Department of Pediatrics, King Fahad Hospital of the University, Al-Khobar, Saudi Arabia.
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Corica D, Bottari A, Aversa T, Morabito LA, Curatola S, Alibrandi A, Ascenti G, Wasniewska M. Prospective assessment of liver stiffness by shear wave elastography in childhood obesity: a pilot study. Endocrine 2022; 75:59-69. [PMID: 34302259 DOI: 10.1007/s12020-021-02828-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 07/12/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE The increased incidence of childhood obesity and related non-alcoholic fatty liver disease (NAFLD) has determined the need to identify a non-invasive technique to diagnose and monitor NAFLD. Two-dimensional shear wave elastography (2D-SWE) has emerged as a reliable, non-invasive, tool to evaluate liver tissue elasticity in clinical practice. Aims of this study were to longitudinally evaluate 2D-SWE changes in relation to weight loss, metabolic profile, and body composition modifications and to investigate the correlation between 2D-SWE variation and clinical and biochemical indices of cardio-metabolic risk in obese children. METHODS Thirty-three children underwent anthropometric, bioimpedenziometric, fasting biochemical assessments, ultrasound, and SWE evaluations, at baseline (V0) and after a 12-months of follow-up (V12). Diet and physical activity programs have been prescribed to all patients according to European Society of Endocrinology and Pediatric Endocrine Society recommendations. Adherence to the prescribed diet and physical activity program was checked every 3 months during the 12-month of follow-up. Variation of all parameters was evaluated in intragroup and intergroup comparison analysis in children, who had not lost weight (Group A) and those who had lost weight (Group B) at V12. Study population was also analyzed dividing it into two groups with respect to 2D-SWE liver elasticity value ≤10.6 kPa or >10.6 kPa. RESULTS A significant reduction of mean 2D-SWE value was demonstrated both in the entire cohort (p = 0.002) and in Group B children (p = 0.004). Intragroup comparison analysis, between V0 and V12, documented a significant decrease of 2D-SWE and BMI SDS and a significant improvement of metabolic profile (decrease of HOMA-IR, HbA1c, oral glucose tolerance test 120-min glucose and insulin, triglycerides, triglycerides/HDL-ratio, transaminases, uric acid, and increase of Matsuda-index and HDL) in children of Group B but not in those of Group A. Intergroup comparison analysis showed significant differences for BMI, BMI SDS, transaminases and several parameters of glucose and lipid metabolism, between Group A and Group B children after 12-months of follow-up. No significant differences were documented with regard to clinical and biochemical variables by dividing the population in accordance with the 2D-SWE cut-off of 10.6 kPa. CONCLUSIONS These results suggested a relation between weight loss, metabolic profile improvement and 2D-SWE value reduction. SWE could play a significant role in the non-invasive assessment of NAFLD in children and adolescents with obesity.
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Affiliation(s)
- Domenico Corica
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
| | - Antonio Bottari
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Messina, Italy
| | - Tommaso Aversa
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Letteria Anna Morabito
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Selenia Curatola
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | | | - Giorgio Ascenti
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Messina, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
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Fatty Liver through the Ages- Non-Alcoholic Steatohepatitis (NASH). Endocr Pract 2021; 28:204-213. [PMID: 34952219 DOI: 10.1016/j.eprac.2021.12.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The global epidemic of obesity and type 2 diabetes mellitus is the main driver of the growing global prevalence of non-alcoholic fatty liver disease (NAFLD). We aimed to review the current literature on NAFLD and NASH as it impacts children and adults. METHODS We performed a literature search on fatty liver specifically non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) among children and adults. RESULTS The prevalence of NAFLD in children ranges from 8%-12% while the prevalence in adults ranges 25%-48%. The prevalence of NASH among children with NAFLD is 23% while it ranges from 13% to 65% in the adults. There are similar risk factors for NAFLD among children and adults. However, in children, the diagnostic tests in the studies of NAFLD are limited to elevation of ALT level or a liver biopsy. In adults, additional diagnostic modalities, including non-invasive tests (NITs), have been used. From the spectrum of NAFLD, those with NASH are predominantly at risk of progressive liver disease to cirrhosis and liver-related mortality. NAFLD is associated with impairment of health-related quality of life and substantial economic burden. CONCLUSION The comprehensive burden (clinical, HRQL and economic) of NAFLD is high and increasing.
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On the Relationship Between Non-alcoholic Fatty Liver Disease with Body Composition and Bone Mineral Density in Overweight/Obese Adolescents. HEPATITIS MONTHLY 2021. [DOI: 10.5812/hepatmon.112184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is a health problem growing in line with the rising prevalence of obesity in children and adolescents, which may be correlated with different metabolic abnormalities such as osteoporosis. Objectives: This study aimed to evaluate the possible relationship between NAFLD with body composition and bone mineral density (BMD) in obese and overweight adolescents. Methods: This cross-sectional study encompassed 70 adolescents aged 11 - 18 years and was conducted during March 2016 and September 2016 in Mashhad, Iran. Anthropometric parameters and blood biomarkers were measured. Fat mass, fat-free mass, and BMD were determined using dual-energy X‐ray absorptiometry (DXA) scans, and NAFLD was also assessed using Fibroscan. All statistical data were analyzed using SPSS software version 21. Multivariate linear regression assessed the relationship between liver fat content with bone-related indicators, and multivariate logistic regression detected the relationship between body composition and NAFLD. Results: Total and trunk fat mass were significantly correlated with higher NAFLD even after controlling for intervening factors (total fat mass, OR = 1.27; 95% CI, 1.016 to 1.59, P = 0.036; trunk fat mass, OR = 1.35; 95% CI, 0.97 to 1.88, P = 0.045). Moreover, liver fat content was significantly correlated with lower BMD Z-score after adjusting for gender, BMI Z-score, ALT, fat mass index, total lean mass, and physical activity (β = -0.285, P = 0.048). Conclusions: The findings of the present study suggest that excess adipose tissue is correlated with higher NAFLD. Moreover, liver steatosis may be correlated with decreased BMD Z-score in overweight/obese adolescents.
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Alberti G, Gana JC, Santos JL. Fructose, Omega 3 Fatty Acids, and Vitamin E: Involvement in Pediatric Non-Alcoholic Fatty Liver Disease. Nutrients 2020; 12:nu12113531. [PMID: 33212947 PMCID: PMC7698421 DOI: 10.3390/nu12113531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/30/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is currently the most common form of liver disease in both adults and children, becoming the leading cause for liver transplant in many countries. Its prevalence has increased considerably in recent years, mainly due to the explosive increase in pediatric obesity rates. NAFLD is strongly associated with central obesity, diabetes, dyslipidemia and insulin resistance, and it has been considered as the hepatic manifestation of the metabolic syndrome. Its complex pathophysiology involves a series of metabolic, inflammatory and oxidative stress processes, among others. Given the sharp increase in the prevalence of NAFLD and the lack of an appropriate pharmacological approach, it is crucial to consider the prevention/management of the disease based on lifestyle modifications such as the adoption of a healthy nutrition pattern. Herein, we review the literature and discuss the role of three key nutrients involved in pediatric NAFLD: fructose and its participation in metabolism, Omega-3 fatty acids and its anti-inflammatory effects and vitamin E and its action on oxidative stress.
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Affiliation(s)
- Gigliola Alberti
- Gastroenterology and Nutrition Department, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 3580000, Chile; (G.A.); (J.C.G.)
| | - Juan Cristóbal Gana
- Gastroenterology and Nutrition Department, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 3580000, Chile; (G.A.); (J.C.G.)
| | - José L. Santos
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 3580000, Chile
- Correspondence: ; Tel.: +56-2-2354-3868
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AlKhater SA. Dynamic Interplay Between Microbiota and Mucosal Immunity in Early Shaping of Asthma and its Implication for the COVID-19 Pandemic. J Asthma Allergy 2020; 13:369-383. [PMID: 33061464 PMCID: PMC7532070 DOI: 10.2147/jaa.s272705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 09/06/2020] [Indexed: 12/11/2022] Open
Abstract
The crosstalk between host immunity and the external environment in the mucous membranes of the gastrointestinal and respiratory tracts in bronchial asthma has recently been scrutinized. There is compelling evidence that the microbiota at these sites may play an important role in the pathogenesis of this chronic airway disease. The appearance of bacteria early in life in the gut before dissemination to the airways plays a pivotal role in shaping mucosal immunity. Loss of microbial diversity or dysbiosis can result in aberrant immune-mediated inflammation and mucosal barrier disruption, which coincides clinically with the successive development of the "allergic march" in asthma. Microbial manipulation may be effective in curbing asthma development by indirectly preserving homeostatic epithelial barrier functions. The protective effects and mechanisms of immunity-microbiome crosstalk at mucosal sites require further investigation to identify therapeutic and preventive measures in asthma. This topical review aims to highlight new evidence that compromised epithelial barrier function, which results in deregulated crosstalk between the microbiome and host mucosal immune system, is an important disease mechanism in asthma. In the light of current COVID-19 pandemic, the collective findings on the impact of mucosal microbiota on the suceptibility to SARS-CoV-2 infection and severity of COVID-19 is explored. The possible therapeutic implications to target these abnormalities are further discussed.
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Affiliation(s)
- Suzan A AlKhater
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Department of Pediatrics, King Fahad Hospital of the University, Al-Khobar, Saudi Arabia
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Gender-specific differences in clinical and metabolic variables associated with NAFLD in a Mexican pediatric population. Ann Hepatol 2020; 18:693-700. [PMID: 31151875 DOI: 10.1016/j.aohep.2019.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 04/05/2019] [Accepted: 02/08/2019] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and it is more prevalent in Hispanic males. The gender differences can be explained by body fat distribution, lifestyle, or sex hormone metabolism. We evaluated anthropometric and metabolic differences by gender in children with and without NAFLD. METHODS We included 194 participants (eutrophic, overweight, and individuals with obesity). The presence of NAFLD was determined using ultrasonography, and we evaluated the association between this disease with metabolic and anthropometric variables by gender. RESULTS The mean age was 10.64±2.54 years. The frequency of NAFLD in boys was 24.51% and in girls was 11.96% (OR=2.39; 95%CI=1.10-5.19; p=0.025). For girls, NAFLD was significantly associated with triglycerides (p=0.012), homeostatic model assessment of insulin resistance (HOMA-IR) (p=0.048), and the visceral adiposity index (VAI) (p=0.024). The variables related to NAFLD in a gender-specific manner were body mass index (BMI) (p=0.001), waist circumference (WC) (p<0.001), HDL cholesterol (p=0.021), alanine aminotransferase (ALT) (p<0.001), and aspartate aminotransferase (AST) (p=0.002). CONCLUSIONS In our study NAFLD is more frequent in boys, only ALT, and no other clinical or metabolic variables, were associated with NAFLD in these patients. HOMA-IR, VAI, triglyceride levels, and ALT were associated with NAFLD only in girls. The ALT cut-off points for the development of NAFLD in our study were 28.5U/L in females and 27.5U/L in males. Our findings showed that NAFLD should be intentionally screened in patients with obesity, particularly in boys.
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Selladurai S, Verma A, Thittai AK. Toward Quantitative and Operator-independent Quasi-static Ultrasound Elastography: An Ex Vivo Feasibility Study. ULTRASONIC IMAGING 2020; 42:179-190. [PMID: 32450766 DOI: 10.1177/0161734620921532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
It is known that the elasticity of liver reduces progressively in the case of diffuse liver disease. Currently, the diagnosis of diffuse liver disease requires a biopsy, which is an invasive procedure. In this paper, we evaluate and report a noninvasive method that can be used to quantify liver stiffness using quasi-static ultrasound elastography approach. Quasi-static elastography is popular in clinical applications where the qualitative assessment of relative tissue stiffness is enough, whereas its potential is relatively underutilized in liver imaging due to lack of local stiffness contrast in the case of diffuse liver disease. Recently, we demonstrated an approach of using a calibrated reference layer to produce quantitative modulus elastograms of the target tissue in simulations and phantom experiments. In a separate work, we reported the development of a compact handheld device to reduce inter- and intraoperator variability in freehand elastography. In this work, we have integrated the reference layer with a handheld controlled compression device and evaluate it for quantitative liver stiffness imaging application. The performance of this technique was assessed on ex vivo goat liver samples. The Young's modulus values obtained from indentation measurements of liver samples acted as the ground truth for comparison. The results from this work demonstrate that by combining the handheld device along with reference layer, the estimated Young's modulus value approaches the ground truth with less error compared with that obtained using freehand compression (8% vs. 15%). The results suggest that the intra- and interoperator reproducibility of the liver elasticity also improved when using the handheld device. Elastography with a handheld compression device and reference layer is a reliable and simple technique to provide a quantitative measure of elasticity.
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Affiliation(s)
- Sathiyamoorthy Selladurai
- Biomedical Ultrasound Laboratory, Biomedical Engineering Group, Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, India
| | - Abhilash Verma
- Biomedical Ultrasound Laboratory, Biomedical Engineering Group, Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, India
| | - Arun K Thittai
- Biomedical Ultrasound Laboratory, Biomedical Engineering Group, Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, India
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Sengul C, Cakir C, Barutcu S, Sarikaya R. The prevalence and correlates of T-wave inversion in lead III in non-obese men. J Electrocardiol 2020; 61:66-70. [PMID: 32554158 DOI: 10.1016/j.jelectrocard.2020.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/05/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND T-wave inversion in lead III was linked to displacement of the base of the heart due to abdominal adipose tissue in early electrocardiography (ECG) trials. The observation of T-wave inversion in lead III in some of the pathological and physiological conditions other than obesity suggests the possibilities of different mechanisms. We aimed to investigate the prevalence and correlates of T-wave inversion in lead III in non-obese men. METHOD A total of 1240 men underwent ECG, blood pressure measurement, hepatic ultrasonography, and biochemical tests from January 2019 to December 2019. We excluded 220 subjects due to predetermined criteria. The eligible 105 non-obese men with T-wave inversion in lead III and 915 non-obese men without T-wave inversion in lead III were compared with each other in terms of clinical, demographic and laboratory parameters. RESULTS The mean age was 27.9 years with a range of 20 to 46 years. The prevalence of T-wave inversion in lead III was 10.3%. Body mass index (BMI), blood urea nitrogen, creatinine, alanine aminotransferase, hematocrit, and the percentage of non-alcoholic fatty liver disease (NAFLD) were significantly higher in Group with T-wave inversion while alkaline phosphatase was significantly higher in Group without T-wave inversion. In multivariable analysis, NAFLD was the best independent correlate of inverted T-wave in lead III (β = 6.215, p < 0.0001). BMI (β = 1.448, p < 0.001) and hematocrit (β = 1.179, p = 0.021) were the other independent correlates of T-wave inversion in lead III. CONCLUSION We demonstrated the association of T-wave inversion in lead III with NAFLD, BMI, and hematocrit in non-obese men.
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Affiliation(s)
- Cihan Sengul
- Department of Cardiology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey.
| | - Cayan Cakir
- Department of Cardiology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
| | - Suleyman Barutcu
- Department of Cardiology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
| | - Remzi Sarikaya
- Department of Cardiology, University of Health Sciences, Van Education and Research Hospital, Van, Turkey
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Li J, Hua W, Ji C, Rui J, Zhao Y, Xie C, Shi B, Yang X. Effect of the patatin-like phospholipase domain containing 3 gene (PNPLA3) I148M polymorphism on the risk and severity of nonalcoholic fatty liver disease and metabolic syndromes: A meta-analysis of paediatric and adolescent individuals. Pediatr Obes 2020; 15:e12615. [PMID: 32020770 DOI: 10.1111/ijpo.12615] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/06/2019] [Accepted: 12/19/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND The effect of the patatin-like phospholipase domain containing 3 gene (PNPLA3) I148M polymorphism on the risk and severity of paediatric and adolescent nonalcoholic fatty liver disease (NAFLD) remains inconclusive. OBJECTIVES We aimed to estimate the effect of this polymorphism not only on early-onset NAFLD risk and severity but also on metabolic syndromes susceptibility. METHODS A systematic literature search was performed to identify relevant datasets. The odds ratio of the dichotomic variables and the standardized mean difference of quantitative variables with corresponding 95% confidence intervals were calculated to assess the strength of the associations. RESULTS Twenty-seven studies comprising 10 070 subjects were eligible. The summary effect showed that this polymorphism increased susceptibility to NAFLD development. Furthermore, it also indicated that nonalcoholic steatohepatitis (NASH) was more frequently observed in G allele carriers among paediatric and adolescent NAFLD patients. Moreover, the meta-analysis suggested that the variant was significantly associated with elevated liver damage indexes, including serum alanine transaminase, aspartate transaminase, gamma-glutamyltransferase concentrations, and liver fat content. However, the summary estimates for insulin resistance, lipid metabolism, and adiposity showed no significant associations. CONCLUSIONS The PNPLA3 I148M polymorphism is associated with elevated early-onset NAFLD risk, severity, and liver damage but not with related metabolic syndromes.
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Affiliation(s)
- Jiaying Li
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China.,Medical College, Soochow University, Suzhou, China
| | - Wenxi Hua
- Medical College, Soochow University, Suzhou, China
| | - Cheng Ji
- School of Biology and Basic Medical Sciences, Soochow University, Suzhou, China
| | - Jingwen Rui
- Medical College, Soochow University, Suzhou, China
| | - Yuening Zhao
- Medical College, Soochow University, Suzhou, China
| | - Chenyao Xie
- Medical College, Soochow University, Suzhou, China
| | - Bimin Shi
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoqin Yang
- School of Biology and Basic Medical Sciences, Soochow University, Suzhou, China
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The Effect of a Family-Based Lifestyle Education Program on Dietary Habits, Hepatic Fat and Adiposity Markers in 8-12-Year-Old Children with Overweight/Obesity. Nutrients 2020; 12:nu12051443. [PMID: 32429379 PMCID: PMC7284532 DOI: 10.3390/nu12051443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 12/18/2022] Open
Abstract
Healthy lifestyle education programs are recommended for obesity prevention and treatment. However, there is no previous information on the effects of these programs on the reduction of hepatic fat percentage. The aims were (i) to examine the effectiveness of a 22-week family-based lifestyle education program on dietary habits, and (ii) to explore the associations of changes in dietary intake with percent hepatic fat reduction and adiposity in children with overweight/obesity. A total of 81 children with overweight/obesity (aged 10.6 ± 1.1 years, 53.1% girls) and their parents attended a 22-week family based healthy lifestyle and psychoeducational program accompanied with (intensive group) or without (control) an exercise program. Hepatic fat (magnetic resonance imaging), adiposity (dual energy X-ray absorptiometry) and dietary habits (two non-consecutive 24 h-recalls) were assessed before and after the intervention. Energy (p < 0.01) fat (p < 0.01) and added sugar (p < 0.03) intake were significantly reduced in both groups at the end of the program, while, in addition, carbohydrates intake (p < 0.04) was reduced exclusively in the control group, and simple sugar (p < 0.05) and cholesterol (p < 0.03) intake was reduced in the exercise group. Fruit (p < 0.03) and low-fat/skimmed dairy consumption (p < 0.02), the adherence to the Mediterranean Diet Quality Index for children and teenagers (KIDMED, p < 0.01) and breakfast quality index (p < 0.03) were significantly higher in both control and intervention groups after the intervention. Moreover, participants in the exercise group increased the adherence to the Dietary Approaches to Stop Hypertension (DASH) diet (p < 0.001), whereas the ratio of evening-morning energy intake was significantly lower exclusively in the control group after the program (p < 0.02). Changes in energy intake were significantly associated with changes in fat mass index (FMI) in the exercise group, whereas changes in sugar-sweetened beverages (SSB) consumption was associated with percent hepatic fat reduction (p < 0.05) in the control group. A 22-week family-based healthy lifestyle program seems to be effective on improving diet quality and health in children with overweight/obesity and these should focus on SSB avoidance and physical activity.
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Brand C, Martins CMDL, Lemes VB, Pessoa MLF, Dias AF, Cadore EL, Mota J, Gaya ACA, Gaya AR. Effects and prevalence of responders after a multicomponent intervention on cardiometabolic risk factors in children and adolescents with overweight/obesity: Action for health study. J Sports Sci 2020; 38:682-691. [PMID: 32050850 DOI: 10.1080/02640414.2020.1725384] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study aimed to verify the effect of a multicomponent intervention on cardiometabolic risk factors (CMRF), and to determine the prevalence of responders on CMRF among children and adolescents with overweight/obesity. This is a quasi-experimental study, developed with 35 children and adolescents with overweight/obesity (control group (CG) = 18; intervention group (IG) = 17), aged between 7 and 13 years. Participants in IG underwent a multicomponent intervention for 12 weeks. The following variables were evaluated: anthropometric measures, maturational stages and CMRF (body fatness, HOMA-IR, triglycerides, high-density and low-density lipoprotein) (HDL-C, LDL-C), total cholesterol (TC), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and AST/ALT ratio. Mixed analysis of variance and the prevalence of responders were used for statistical analysis. There was a significant time x group interaction on body fatness (p < 0.001), HOMA-IR (p = 0.01), HDL-C (p < 0.001), LDL-C (p = 0.009) and TC (p < 0.001). The prevalence of responders for CMRF in IG and CG was respectively: body fatness (47%; 0%; p = 0.04), HOMA-IR (58.8%; 16.6%; p = 0.04); triglycerides (17.6%; 5.5%; p = 0.31); HDL-C (76.4%; 5.5%; p = 0.01), LDL-C (35.3%; 5%; p = 0.08), TC (64.7%; 5%; p = 0.01), AST (5.8%; 0%; p = 0.87), ALT (29.4%; 11.1%; p = 0.24) and AST/ALT ratio (24.4%; 22.2%; p = 0.67). Multicomponent intervention induced positive changes on CMRF along with a higher prevalence of positive adaptations in IG than the CG in some of the cardiometabolic outcomes assessed.
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Affiliation(s)
- Caroline Brand
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Vanilson Batista Lemes
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maria Luisa Félix Pessoa
- Research Center on Physical Activity, Health and Leisure, Federal University of Paraiba, João Pessoa, Brazil.,Health Science Centre, Federal University of Paraíba, João Pessoa, Brazil
| | - Arieli Fernandes Dias
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Eduardo Lusa Cadore
- School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Jorge Mota
- Research Center on Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Adroaldo Cezar Araujo Gaya
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Anelise Reis Gaya
- Projeto Esporte Brasil (PROESP-Br). School of Physical Education, Physiotherapy and Dance, Post-graduation Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Zhang S, Wang Y, Wang Z, Wang H, Xue C, Li Q, Guan W, Yuan J. Rotating night shift work and non-alcoholic fatty liver disease among steelworkers in China: a cross-sectional survey. Occup Environ Med 2020; 77:333-339. [PMID: 32019846 DOI: 10.1136/oemed-2019-106220] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 12/13/2019] [Accepted: 12/31/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVES In a 24/7 society, the negative metabolic effects of rotating night shift work have been increasingly explored. This study aimed to examine the association between rotating night shift work and non-alcoholic fatty liver disease (NAFLD) in steelworkers. METHODS A total of 6881 subjects was included in this study. Different exposure metrics of night shift work including current shift status, duration of night shifts (years), cumulative number of night shifts (nights), cumulative length of night shifts (hours), average frequency of night shifts (nights/month) and average length of night shifts (hours/night) were used to examine the relationship between night shift work and NAFLD. RESULTS Current night shift workers had elevated odds of NAFLD (OR, 1.23, 95% CI 1.02 to 1.48) compared with those who never worked night shifts after adjustment for potential confounders. Duration of night shifts, cumulative number of night shifts and cumulative length of night shifts were positively associated with NAFLD. Both the average frequency of night shifts (>7 nights/month vs ≤7 nights/month: OR, 1.24, 95% CI 1.06 to 1.45) and average length of night shifts (>8 hours/night vs ≤8 hours/night: OR, 1.27, 95% CI 1.08 to 1.51) were independently associated with overall NAFLD after mutually adjusting for the duration of night shifts and other potential confounders among night shift workers. No significant association was found in female workers between different exposure metrics of night shift work and NAFLD. CONCLUSIONS Rotating night shift work is associated with elevated odds of NAFLD in male steelworkers.
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Affiliation(s)
- Shengkui Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yongbin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, Henan, China
| | - Zhende Wang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Han Wang
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Chao Xue
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Qinglin Li
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Weijun Guan
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Juxiang Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
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Abstract
UNLABELLED Nonalcoholic fatty liver disease (NAFLD), defined as fat accumulation greater than 5% in hepatocytes, may progress to fibrosis or cirrhosis later in life. NAFLD prevalence in adolescents has increased significantly in direct relation with obesity prevalence. Fatty liver has become the most frequent indication for liver transplantation in adults. OBJECTIVE The aim of the study was to identify anthropometric variables during the first 10 years of life associated to the risk of developing NAFLD in adolescence. METHODS Longitudinal cohort study 'Growth and Obesity Chilean Cohort Study' (GOCS) consisting of 513 children born in 2002 to 2003, with yearly anthropometric data collected over a 10-year period. The presence of intrahepatic fat in the livers of subjects 14 to 16 years of age was determined using abdominal ultrasound. In addition, elastography was performed on all participants with ultrasound evidence of NAFLD. RESULTS 9.7% of the participants presented findings compatible with NAFLD. After 2 years of age, obesity significantly and progressively increased the probability of NAFLD occurrence in adolescence. Obesity at 5 years of age was associated with the highest OR for NAFLD, reaching values of 8.91 (95% CI 3.03-16.11). Among participants with NAFLD, those with altered liver elasticity (≥7 kPa) had greater weight, BMI z-score, waist and hip circumference, and altered liver enzymes (P < 0.05). CONCLUSION The risk of developing NAFLD in adolescence increases progressively with early obesity starting at age 2 years.
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18
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Dietary determinants of hepatic fat content and insulin resistance in overweight/obese children: a cross-sectional analysis of the Prevention of Diabetes in Kids (PREDIKID) study. Br J Nutr 2019; 121:1158-1165. [PMID: 30832745 DOI: 10.1017/s0007114519000436] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Paediatric non-alcoholic fatty liver disease has increased in parallel with childhood obesity. Dietary habits, particularly products rich in sugars, may influence both hepatic fat and insulin resistance (homeostatic model assessment for insulin resistance (HOMA-IR)). The aim of the study was to examine the association of the consumption of foods and food components, dairy desserts and substitutes (DDS), sugar-sweetened beverages (SSB), as well as total and added sugars, with hepatic fat and HOMA-IR. Dietary intake (two non-consecutive 24 h-recalls), hepatic fat (MRI) and HOMA-IR were assessed in 110 overweight/obese children (10·6 (sd 1·1) years old). Linear regression analyses were used to examine the association of dietary intake with hepatic fat and HOMA-IR adjusted for potential confounders (sex, age, energy intake, maternal educational level, total and abdominal adiposity and sugar intake). The results showed that there was a negative association between cereal intake and hepatic fat (β=-0·197, P<0·05). In contrast, both SSB consumption (β=0·217; P=0·028) and sugar in SSB (β=0·210, P=0·035), but not DDS or sugar in DDS or other dietary components, were positively associated with hepatic fat regardless of potential confounders including total sugar intake. In conclusion, cereal intake might decrease hepatic fat, whereas SSB consumption and its sugar content may increase the likelihood of having hepatic steatosis. Although these observations need to be confirmed using experimental evidence, these results suggest that healthy lifestyle intervention programs are needed to improve dietary habits as well as to increase the awareness of the detrimental effects of SSB consumption early in life.
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Sun Y, Dai W, Liang Y, Yang P, Yang Q, Liang M, Xia N. Relationship between nonalcoholic fatty liver disease and bone mineral density in adolescents with obesity: a meta-analysis. Diabetes Metab Syndr Obes 2019; 12:199-207. [PMID: 30787626 PMCID: PMC6363492 DOI: 10.2147/dmso.s192256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Many studies have reported the relationship between nonalcoholic fatty liver disease (NAFLD) and bone mineral density (BMD) among adults. However, fewer studies on this topic have been reported in adolescents. We thus conducted a meta-analysis to show the association between NAFLD and BMD in adolescents with obesity. MATERIALS AND METHODS Computer retrieval was carried out via PubMed, Embase, Cochrane Library and the Cochrane Central Register of Controlled Trials from inception to September 2018. Six published case-control studies that assessed the relationship between NAFLD and BMD were included. RESULTS The six studies included 217 obese adolescents with NAFLD and 236 controls. The meta-analysis indicated that obese children with NAFLD had a lower BMD and Z-score than the control group (weighted mean difference [WMD]-0.03, 95% CI [-0.05, -0.02], P=0.000; [WMD] -0.26, 95% CI [-0.37, -0.14], P=0.000). However, we analyzed the factor of bone mineral content, and there was no correlation between the two groups ([WMD]-55.99, 95% CI [-132.16, 20.18], P=0.150). CONCLUSION Obese children with NAFLD are more susceptible to osteoporosis than children with only obesity. Because of the limitations related to the quantity and quality of the included literature, further studies are still needed.
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Affiliation(s)
- Yue Sun
- Geriatric Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China,
| | - Weiran Dai
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Yuzhen Liang
- Department of Endocrinology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Pijian Yang
- Geriatric Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China,
| | - Qiong Yang
- Geriatric Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China,
| | - Min Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Ning Xia
- Geriatric Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China,
- Department of Science and Technology Education, Guangxi Zhuang Autonomous Region Health Committee, Nanning, Guangxi, People's Republic of China
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20
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Hepatic fat content and bone mineral density in children with overweight/obesity. Pediatr Res 2018; 84:684-688. [PMID: 30120405 DOI: 10.1038/s41390-018-0129-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 06/08/2018] [Accepted: 07/11/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To examine the influence of non-alcoholic fatty liver disease (NAFLD) and hepatic fat content on bone mineral density (BMD), and to investigate whether the relationship between NAFLD and BMD is independent of lifestyle factors related to BMD. METHODS Hepatic fat content (magnetic resonance imaging), BMD, lean mass index, total and abdominal fat mass (dual-energy-X-ray absorptiometry), moderate to vigorous physical activity (MVPA) (accelerometry), and calcium and vitamin D intake (two 24 h recalls) were measured in 115 children with overweight/obesity aged 10.6 ± 1.1 years old. RESULTS Children with NAFLD had lower BMD than children without NAFLD regardless of sex, puberty stage, lean mass index, fat mass, MVPA, and calcium and vitamin D intake (0.89 ± 0.01 vs. 0.93 ± 0.01 g/cm2 for NAFLD and non-NAFLD, respectively, P < 0.01). Higher hepatic fat content was significantly associated with lower BMD regardless of confounders (adjusted P < 0.05). CONCLUSIONS Findings of the current study suggest that hepatic fat accumulation is associated with decreased BMD independently of adiposity, and regardless of those lifestyle factors closely related to bone mineral accrual in children. These results may have implication in the clinical management of children with overweight/obesity given the high prevalence of pediatric NAFLD.
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Evidence-Based Exercise Recommendations to Reduce Hepatic Fat Content in Youth- a Systematic Review and Meta-Analysis. Prog Cardiovasc Dis 2018; 61:222-231. [PMID: 29452135 DOI: 10.1016/j.pcad.2018.01.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 01/31/2018] [Indexed: 12/18/2022]
Abstract
The main purposes of this study were to elucidate the effects of supervised-exercise training (ET) interventions on hepatic fat content and on non-alcoholic fatty liver disease (NAFLD) prevalence in children and adolescents and to provide information about the optimal ET prescription (type, intensity, volume, and frequency) needed to reduce hepatic fat content in youths. Supervised-ET interventions performed in children and adolescents (6-19 years) that provided results of exercise effects on hepatic fat content or NAFLD prevalence were included. Supervised-exercise significantly reduced hepatic fat content compared to the control groups. Lifestyle interventions that included supervised-ET significantly reduced the prevalence of NAFLD. This systematic review and meta-analysis shows that supervised-ET could be an effective strategy in the management and prevention of NAFLD in children and adolescents. Both aerobic and resistance ET, at vigorous or moderate-to-vigorous intensities, with a volume ≥60 min/session and a frequency ≥3 sessions/week, aiming to improve cardiorespiratory fitness and muscular strength, had benefits on hepatic fat content reduction in youth. These data concur with the international recommendations of physical activity for health promotion in youth and may be useful when designing ET programs to improve and prevent hepatic steatosis in the pediatric population.
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Berná-Serna JD, Sánchez-Jiménez R, Velázquez-Marín F, Sainz de Baranda P, Guzmán-Aroca F, Fernández-Hernández C, Doménech-Abellán E, Abellán-Rivero D, Ruiz-Merino G, Madrid-Conesa J, Canteras-Jordana M. Acoustic radiation force impulse imaging for detection of liver fibrosis in overweight and obese children. Acta Radiol 2018; 59:247-253. [PMID: 28475023 DOI: 10.1177/0284185117707359] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Acoustic radiation force impulse (ARFI) is a non-invasive alternative to a liver biopsy for the evaluation of liver fibrosis (LF). Purpose To investigate the potential usefulness of acoustic radiation force impulse ARFI for detecting LF in overweight and obese children Material and Methods A cross-sectional study was conducted in 148 schoolchildren. A diagnosis of non-alcoholic fatty liver disease (NAFLD) and LF was based on ultrasound (US) and ARFI shear wave velocity (SWV). Results The laboratory parameters were normal in all the children. NAFLD was observed in 50 children (33.8%). The median SWV was 1.18 ± 0.28 m/s. Differences between ARFI categories and hepatic steatosis grades were observed (χ2 = 43.38, P = 0.0005). No fibrosis or insignificant fibrosis (SWV ≤ 1.60 m/s) was detected in 137 children (92.5%), and significant fibrosis (SWV > 1.60 m/s) in 11 children (7.5%), nine of whom had normal US or mild steatosis. Conclusion The present study is the first to evaluate the utility of the ARFI technique for detecting LF in overweight and obese children. The results of the study suggest that children with normal laboratory parameters such as normal liver ultrasound or mild steatosis may present with significant LF.
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Affiliation(s)
- Juan D Berná-Serna
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Regina Sánchez-Jiménez
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Francisca Velázquez-Marín
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | | | - Florentina Guzmán-Aroca
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Carmen Fernández-Hernández
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Ernesto Doménech-Abellán
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | - Dolores Abellán-Rivero
- Department of Radiology, Virgen de la Arrixaca University Clinical Hospital- IMIB, Ctra. Madrid-Cartagena, 30120, El Palmar (Murcia), Spain
| | | | - Juan Madrid-Conesa
- Department of Endocrinology and Nutrition, Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
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Li H, Canet MJ, Clarke JD, Billheimer D, Xanthakos SA, Lavine JE, Erickson RP, Cherrington NJ. Pediatric Cytochrome P450 Activity Alterations in Nonalcoholic Steatohepatitis. Drug Metab Dispos 2017; 45:1317-1325. [PMID: 28986475 PMCID: PMC5697442 DOI: 10.1124/dmd.117.077644] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/28/2017] [Indexed: 01/01/2023] Open
Abstract
Variable drug responses depend on individual variation in the activity of drug-metabolizing enzymes, including cytochrome P450 enzymes (CYP). As the most common chronic liver disease in children and adults, nonalcoholic steatohepatitis (NASH) has been identified as a source of significant interindividual variation in hepatic drug metabolism. Compared with adults, children present age-related differences in pharmacokinetics and pharmacodynamics. The purpose of this study was to determine the impact of fatty liver disease severity on the activity of a variety of CYP enzymes in children and adolescents. Healthy and nonalcoholic fatty liver disease pediatric subjects aged 12-21 years inclusive received an oral cocktail of four probe drugs: caffeine (CYP1A2, 100 mg), omeprazole (CYP2C19, 20 mg), losartan (CYP2C9, 25 mg), and midazolam (CYP3A4, 2 mg). Venous blood and urine were collected before administration and 1, 2, 4, and 6 hours after administration. Concentrations of the parent drugs and CYP-specific metabolites were quantified in plasma and urine using liquid chromatography with tandem mass spectrometry. In plasma, the decreased metabolic area under the curve (AUC) ratio, defined as the metabolite AUC to parent AUC, of omeprazole indicated significant decreases of CYP2C19 (P = 0.002) enzymatic activities in NASH adolescents, while the urine analyses did not show significant differences and were highly variable. A comparison between the present in vivo pediatric studies and a previous ex vivo study in adults indicates distinct differences in the activities of CYP1A2 and CYP2C9. These data demonstrate that pediatric NASH presents an altered pattern of CYP activity and NASH should be considered as a confounder of drug metabolism for certain CYP enzymes. These differences could lead to future investigations that may reveal unexpected variable drug responses that should be considered in pediatric dosage recommendations.
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Affiliation(s)
- Hui Li
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Mark J Canet
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - John D Clarke
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Dean Billheimer
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Stavra A Xanthakos
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Joel E Lavine
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Robert P Erickson
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
| | - Nathan J Cherrington
- Department of Pharmacology and Toxicology (H.L., M.J.C., J.D.C., N.J.C.), Department of Epidemiology and Biostatistics (D.B.), and Department of Pediatrics (R.P.E.), University of Arizona, Tucson, Arizona; Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, Ohio (S.A.X.); Columbia University, New York, New York (J.E.L.)
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Liu F, Zhao JM, Rao HY, Yu WM, Zhang W, Theise ND, Wee A, Wei L. Second Harmonic Generation Reveals Subtle Fibrosis Differences in Adult and Pediatric Nonalcoholic Fatty Liver Disease. Am J Clin Pathol 2017; 148:502-512. [DOI: 10.1093/ajcp/aqx104] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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25
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Hens W, Vissers D, Hansen D, Peeters S, Gielen J, Van Gaal L, Taeymans J. The effect of diet or exercise on ectopic adiposity in children and adolescents with obesity: a systematic review and meta-analysis. Obes Rev 2017; 18:1310-1322. [PMID: 28913977 DOI: 10.1111/obr.12577] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/26/2017] [Accepted: 05/14/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Ectopic fat depostion in youth with obesity is associated with an increased cardiovascular disease risk. The aim of this meta-analysis was to summarize the evidence for the use of diet and/or exercise on ectopic adiposity in this population. METHODS A systematic literature search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. Clinical trials that assessed ectopic fat deposition and included study arms with diet and/or exercise were searched in PubMed, PEDro and the Cochrane database. RESULTS Hepatic fat content and intramyocellular lipid content were described in nine studies and three studies, respectively. Most studies included teenagers, and study duration ranged between 3 and 12 months without follow-up. Using random-effects weights, the standardized mean difference of the change in hepatic adiposity (totalling 320 subjects) was -0.54 Hedges' g (95% confidence interval: -0.69 to -0.38 with p < 0.0001). By re-expressing this effect size, it is seen that diet and/or exercise results in an absolute reduction of intrahepatic lipid with 2%, which accords with a relative reduction up to 70%. Although there were significant ameliorations of insulin sensitivity, no significant changes in intramyocellular lipid were observed. CONCLUSIONS This meta-analysis showed that diet and/or exercise is effective to reduce hepatic adiposity in youth with obesity.
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Affiliation(s)
- W Hens
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - D Vissers
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - D Hansen
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,REVAL-Rehabilitation Research Centre, Diepenbeek, Belgium.,Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - S Peeters
- Flemish Working Group from AXXON, Antwerp, Belgium
| | - J Gielen
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
| | - L Van Gaal
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, Antwerp, Belgium
| | - J Taeymans
- Health, Bern University of Applied Sciences-Health, Bern, Switzerland.,Faculty of Sport and Rehabilitation Sciences, Vrije Universiteit Brussel, Brussels, Belgium
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Wang S, Song J, Yang Y, Zhang Y, Chawla NV, Ma J, Wang H. Interaction between obesity and the Hypoxia Inducible Factor 3 Alpha Subunit rs3826795 polymorphism in relation with plasma alanine aminotransferase. BMC MEDICAL GENETICS 2017; 18:80. [PMID: 28754107 PMCID: PMC5534125 DOI: 10.1186/s12881-017-0437-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 07/13/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Hypoxia Inducible Factor 3 Alpha Subunit (HIF3A) DNA has been demonstrated to be associated with obesity in the methylation level, and it also has a Body Mass Index (BMI)-independent association with plasma alanine aminotransferase (ALT). However, the relation among obesity, plasma ALT, HIF3A polymorphism and methylation remains unclear. This study aims to identify the association between HIF3A polymorphism and plasma ALT, and further to determine whether the effect of HIF3A polymorphism on ALT could be modified by obesity or mediated by DNA methylation. METHODS The HIF3A rs3826795 polymorphism was genotyped in a case-control study including 2030 Chinese children aged 7-18 years (705 obese cases and 1325 non-obese controls). Furthermore, the HIF3A DNA methylation of the peripheral blood was measured in 110 severely obese children and 110 age- and gender- matched normal-weight controls. RESULTS There was no overall association between the HIF3A rs3826795 polymorphism and ALT. A significant interaction between obesity and rs3826795 in relation with ALT was found (P inter = 0.042), with rs3826795 G-allele number elevating ALT significantly only in obese children (β' = 0.075, P = 0.037), but not in non-obese children (β' = -0.009, P = 0.741). Additionally, a mediation effect of HIF3A methylation was found in the association between the HIF3A rs3826795 polymorphism and ALT among obese children (β' = 0.242, P = 0.014). CONCLUSION This is the first study to report the interaction between obesity and HIF3A gene in relation with ALT, and also to reveal a mediation effect among the HIF3A polymorphism, methylation and ALT. This study provides new evidence to the function of HIF3A gene, which would be helpful for future risk assessment and personalized treatment of liver diseases.
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Affiliation(s)
- Shuo Wang
- Institute of Child and Adolescent Health of Peking University, School of Public Health, Peking University Health Science Center, Beijing, 100191, China.,Interdisciplinary Center for Network Science and Applications (iCeNSA), University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Jieyun Song
- Institute of Child and Adolescent Health of Peking University, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Yide Yang
- Institute of Child and Adolescent Health of Peking University, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Yining Zhang
- Institute of Child and Adolescent Health of Peking University, School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Nitesh V Chawla
- Interdisciplinary Center for Network Science and Applications (iCeNSA), University of Notre Dame, Notre Dame, IN, 46556, USA.,Department of Computer Science and Engineering, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Jun Ma
- Institute of Child and Adolescent Health of Peking University, School of Public Health, Peking University Health Science Center, Beijing, 100191, China.
| | - Haijun Wang
- Division of Maternal and Child Health, School of Public Health, Peking University Health Science Center, Beijing, 100191, China.
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Selvakumar PKC, Kabbany MN, Nobili V, Alkhouri N. Nonalcoholic Fatty Liver Disease in Children: Hepatic and Extrahepatic Complications. Pediatr Clin North Am 2017; 64:659-675. [PMID: 28502444 DOI: 10.1016/j.pcl.2017.01.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is considered the hepatic manifestation of metabolic syndrome and has become the most common form of chronic liver disease in children and adolescents. The histologic spectrum of NAFLD is broad ranging, from the relatively benign form of simple steatosis to the aggressive form of nonalcoholic steatohepatitis, eventually leading to fibrosis and cirrhosis. NAFLD has also been recognized as an independent risk factor for extrahepatic complications, such as cardiovascular disease, type 2 diabetes mellitus, sleep disorders, and osteoporosis. In this review, we discuss both the hepatic and extrahepatic complications of NAFLD in children.
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Affiliation(s)
| | - Mohammad Nasser Kabbany
- Department of Pediatric Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH, USA
| | - Valerio Nobili
- Liver Unit, IRCCS Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Naim Alkhouri
- Department of Pediatric Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Cleveland, Cleveland Clinic Main Campus, Mail Code A111, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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28
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Cueto-Galán R, Barón FJ, Valdivielso P, Pintó X, Corbella E, Gómez-Gracia E, Wärnberg J. Cambios en el Índice de Hígado Graso con una intervención con dieta mediterránea: seguimiento de 6 años del ensayo PREDIMED-Málaga. Med Clin (Barc) 2017; 148:435-443. [DOI: 10.1016/j.medcli.2016.11.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 11/22/2016] [Accepted: 11/24/2016] [Indexed: 12/22/2022]
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Abstract
Non-alcoholic fatty liver disease (NAFLD) is associated with obesity, insulin resistance, type 2 diabetes and cardiovascular disease and can be considered the hepatic manifestation of the metabolic syndrome. NAFLD represents a spectrum of disease, from the relatively benign simple steatosis to the more serious non-alcoholic steatohepatitis, which can progress to liver cirrhosis, hepatocellular carcinoma and end-stage liver failure, necessitating liver transplantation. Although the increasing prevalence of NAFLD in developed countries has substantial implications for public health, many of the precise mechanisms accounting for the development and progression of NAFLD are unclear. The environment in early life is an important determinant of cardiovascular disease risk in later life and studies suggest this also extends to NAFLD. Here we review data from animal models and human studies which suggest that fetal and early life exposure to maternal under- and overnutrition, excess glucocorticoids and environmental pollutants may confer an increased susceptibility to NAFLD development and progression in offspring and that such effects may be sex-specific. We also consider studies aimed at identifying potential dietary and pharmacological interventions aimed at reducing this risk. We suggest that further human epidemiological studies are needed to ensure that data from animal models are relevant to human health.
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30
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Chen LH, Wang YF, Xu QH, Chen SS. Omega-3 fatty acids as a treatment for non-alcoholic fatty liver disease in children: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr 2016; 37:516-521. [PMID: 28040302 DOI: 10.1016/j.clnu.2016.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 12/08/2016] [Accepted: 12/09/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND The most typical chronic liver disease in children and adolescents is non-alcoholic fatty liver disease (NAFLD). The dietary addition of ω-3 polyunsaturated fatty acids (PUFAs) provides a promising therapy for children with NAFLD due to its convenience and safety; however, several studies suggested contradictory results for PUFA supplementation in children. Hence, we performed a systematic review and meta-analysis to evaluate the effectiveness of PUFA supplementation in children with NAFLD. METHODS Published randomized controlled trials (RCTs) that evaluated the effectiveness of the dietary addition of PUFA in children with NAFLD were considered. The primary result was the alteration in hepatic steatosis grade on ultrasound after treatment. The secondary outcomes included alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP) and components of metabolic syndrome. Predefined sensitivity analysis was also performed to explore possible explanations for heterogeneity in the evaluations. RESULTS In total, 4 studies with 263 subjects were identified. PUFA supplementation was associated with significantly improved hepatic steatosis grade on ultrasound (risk difference: 25%, 95% CI: 12-38%), without heterogeneity (P = 0.27, I2 = 24%). Sensitivity analysis confirmed the robustness of our findings. PUFA supplementation could decrease AST levels after 6 months, but could only reduce ALT levels after 12 months. PUFA did not have a significant effect on most components of metabolic syndrome and the CRP level. CONCLUSION ω-3 PUFA supplementation can improve liver steatosis and liver functions, and it is a potential food supplementation to treat NAFLD in children.
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Affiliation(s)
- Lian-Hui Chen
- Department of Pediatrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yong-Fen Wang
- Department of Pediatrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China.
| | - Qing-Hong Xu
- Department of Pediatrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Shan-Shan Chen
- Department of Intensive Care Unit, The First Hospital of Quanzhou Affiliated to Fujian Medical University, Quanzhou, China
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Strambi M, Giussani M, Ambruzzi MA, Brambilla P, Corrado C, Giordano U, Maffeis C, Maringhin S, Matteucci MC, Menghetti E, Salice P, Schena F, Strisciuglio P, Valerio G, Viazzi F, Virdis R, Genovesi S. Novelty in hypertension in children and adolescents: focus on hypertension during the first year of life, use and interpretation of ambulatory blood pressure monitoring, role of physical activity in prevention and treatment, simple carbohydrates and uric acid as risk factors. Ital J Pediatr 2016; 42:69. [PMID: 27423331 PMCID: PMC4947361 DOI: 10.1186/s13052-016-0277-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 07/05/2016] [Indexed: 02/07/2023] Open
Abstract
The present article intends to provide an update of the article "Focus on prevention, diagnosis and treatment of hypertension in children and adolescents" published in 2013 (Spagnolo et al., Ital J Pediatr 39:20, 2013) in this journal. This revision is justified by the fact that during the last years there have been several new scientific contributions to the problem of hypertension in pediatric age and during adolescence. Nevertheless, for what regards some aspects of the previous article, the newly acquired information did not require substantial changes to what was already published, both from a cultural and from a clinical point of view. We felt, however, the necessity to rewrite and/or to extend other parts in the light of the most recent scientific publications. More specifically, we updated and extended the chapters on the diagnosis and management of hypertension in newborns and unweaned babies, on the use and interpretation of ambulatory blood pressure monitoring, and on the usefulness of and indications for physical activity. Furthermore, we added an entirely new section on the role that simple carbohydrates (fructose in particular) and uric acid may play in the pathogenesis of hypertension in pediatric age.
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Affiliation(s)
- Mirella Strambi
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Dipartimento di Biologia Molecolare e dello Sviluppo, Università di Siena, Siena, Italy
| | - Marco Giussani
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy. .,ASL Milano 1, Novate Milanese Ollearo 2, 20155, Milan, Italy.
| | | | | | - Ciro Corrado
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,UOC Nefrologia Pediatrica A.R.N.A.S. Civico, Di Cristina e Benfratelli, Palermo, Italy
| | - Ugo Giordano
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Alta Specializzazione Ipertensione Arteriosa, UOS Medicina dello Sport, Dipartimento Medico-Chirurgico di Cardiologia Pediatrica, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Claudio Maffeis
- UOC Pediatria ad Indirizzo Dietologico e Malattie del Metabolismo Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Silvio Maringhin
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,UOC Nefrologia Pediatrica A.R.N.A.S. Civico, Di Cristina e Benfratelli, Palermo, Italy.,Società Italiana Nefrologia Pediatrica, Milan, Italy
| | - Maria Chiara Matteucci
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy
| | - Ettore Menghetti
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy
| | - Patrizia Salice
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Cardiologia Perinatale e Pediatrica, UOC Malattie Cardiovascolari, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Società Italiana Cardiologia Pediatrica, Florence, Italy
| | - Federico Schena
- Neonatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pietro Strisciuglio
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Dipartimento di Scienze Mediche Translazionali, Università Federico II Napoli, Naples, Italy
| | - Giuliana Valerio
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, Naples, Italy
| | - Francesca Viazzi
- Dipartimento di Medicina Interna, Università di Genova e IRCCS AOU San Martino-IST, Genoa, Italy
| | - Raffaele Virdis
- Gruppo di Studio Ipertensione Arteriosa Società Italiana di Pediatria, Rome, Italy.,Dipartimento Scienze Biomediche, Biotecnologiche e Traslazionali - S.Bi.Bi.T. Università di Parma, Parma, Italy
| | - Simonetta Genovesi
- Dipartimento di Medicina e Chirurgia, Università di Milano Bicocca, Monza, Italy.,Dipartimento di Scienze Cardiovascolari, Neurologiche e Metaboliche, Ospedale S. Luca, IRCCS, Istituto Auxologico Italiano, Milan, Italy.,Società Italiana Ipertensione Arteriosa, Milan, Italy
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Abstract
NAFLD is now the most common cause of liver disease in Western countries. This Review explores the links between NAFLD, the metabolic syndrome, dysbiosis, poor diet and gut health. Animal studies in which the gut microbiota are manipulated, and observational studies in patients with NAFLD, have provided considerable evidence that dysbiosis contributes to the pathogenesis of NAFLD. Dysbiosis increases gut permeability to bacterial products and increases hepatic exposure to injurious substances that increase hepatic inflammation and fibrosis. Dysbiosis, combined with poor diet, also changes luminal metabolism of food substrates, such as increased production of certain short-chain fatty acids and alcohol, and depletion of choline. Changes to the microbiome can also cause dysmotility, gut inflammation and other immunological changes in the gut that might contribute to liver injury. Evidence also suggests that certain food components and lifestyle factors, which are known to influence the severity of NAFLD, do so at least in part by changing the gut microbiota. Improved methods of analysis of the gut microbiome, and greater understanding of interactions between dysbiosis, diet, environmental factors and their effects on the gut-liver axis should improve the treatment of this common liver disease and its associated disorders.
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Affiliation(s)
- Christopher Leung
- Department of Medicine, The University of Melbourne, Austin Health, Heidelberg, Melbourne, VIC 3084, Australia.,Department of Gastroenterology and Hepatology, Austin Health, Austin Hospital, Heidelberg, Melbourne, VIC 3084, Australia
| | - Leni Rivera
- Metabolic Research Unit, School of Medicine, Deakin University, Geelong, VIC 3216, Australia.,Department of Anatomy and Neuroscience, University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
| | - John B Furness
- Department of Anatomy and Neuroscience, University of Melbourne, Grattan Street, Parkville, VIC 3010, Australia
| | - Peter W Angus
- Department of Medicine, The University of Melbourne, Austin Health, Heidelberg, Melbourne, VIC 3084, Australia.,Department of Gastroenterology and Hepatology, Austin Health, Austin Hospital, Heidelberg, Melbourne, VIC 3084, Australia
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European Obesity Summit (EOS) - Joint Congress of EASOand IFSO-EC, Gothenburg, Sweden, June 1 - 4, 2016: Abstracts. Obes Facts 2016; 9 Suppl 1:1-376. [PMID: 27238363 PMCID: PMC5672850 DOI: 10.1159/000446744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Abstract
OBJECTIVE Ataxia telangiectasia (A-T) is a rare genetic multiorgan disease. Although gastrointestinal involvement is known, hepatic involvement in A-T has not been investigated. We aimed to study the hepatic involvement in a large cohort of patients with A-T. METHODS A retrospective review of patients, studied from January 1986 to January 2015 at a National A-T Center. Clinical data including demographic, genetic, laboratory, nutritional, radiographic, and histological data were retrieved. RESULTS Fifty-three patients, 27 (49%) boys, age 14.6 ± 5.2 years (range 5.9-26.1 years), were included. Twenty-three patients (43.4%), age 9.9 ± 5.1 years, had consistently abnormal liver enzymes. The mean enzyme levels were alanine aminotransferase 76.8 ± 73.8 IU/L, aspartate aminotransferase 70 ± 50 IU/L, alkaline phosphatase 331 ± 134 IU/L, and gamma glutamyl transferase 114.7 ± 8 IU/L. Evaluation of other etiology of liver disease was negative. Ultrasonography revealed fatty liver in 9 of them (39%). Liver biopsy was performed in 2 patients, revealing mild-to-moderate steatosis in both, and fibrosis in 1 patient. Progression to advanced liver disease occurred in 2 of 23 (9%) patients within 2 to 5 years. Dyslipidemia was significantly associated with abnormal liver enzymes: 3 of 30 (10%) patients without abnormal liver enzymes versus 10 of 23 (45.5%) patients with abnormal liver enzymes, respectively (P < 0.05, Fisher exact test). No correlation was found between hepatic involvement and HbA1C, sex, presence of malignancy, or type of mutation. CONCLUSIONS Abnormal liver enzymes and fatty liver are common in patients with A-T and may progress to advanced liver disease at a young age. These findings are novel and implicate that patients with A-T with abnormal liver enzymes should be evaluated for the presence of liver disease.
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Medrano M, Maiz E, Maldonado-Martín S, Arenaza L, Rodríguez-Vigil B, Ortega F, Ruiz J, Larrarte E, Diez-López I, Sarasúa-Miranda A, Tobalina I, Barrenechea L, Pérez-Asenjo J, Kannengiesser S, Manhães-Savio A, Echaniz O, Labayen I. The effect of a multidisciplinary intervention program on hepatic adiposity in overweight-obese children: protocol of the EFIGRO study. Contemp Clin Trials 2015; 45:346-355. [DOI: 10.1016/j.cct.2015.09.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/14/2015] [Accepted: 09/21/2015] [Indexed: 02/07/2023]
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Zhang DF, Zhang F, Zhang J, Zhang RM, Li R. Protection effect of trigonelline on liver of rats with non-alcoholic fatty liver diseases. ASIAN PAC J TROP MED 2015; 8:651-4. [PMID: 26321519 DOI: 10.1016/j.apjtm.2015.07.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 06/20/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To study the effect of trigonelline on the change of indicators of serum transaminase, lipoprotein and liver lipid of model rats with non-alcoholic fatty liver diseases and on the expression level of Bcl-2 and Bax proteins. METHODS A total of 45 SD rats were randomly divided into the control group, model group and trigonelline intervention group. Rats in the control group were fed with the common diet, while rats in the model group and intervention group were fed with the high fat diet. 8 weeks later, the intervention group received the intragastric administration of trigonellin e (with the dosage of 40 mg/kg/d) for 8 weeks; while control group and model group received the intragastric administration of saline with the equal dosage. Blood was taken from the abdominal aorta of rats 8 weeks later, detecting the level of a series of indicators of ALT, AST, TG, TC, HDL-C and LDL-C in the serum. After the rats were sacrificed, detect the indicators of TG, TC, SOD and MDA in the liver tissue of rats, as well as the expression of Bcl-2 and Bax in the liver tissue. RESULTS Results of histopathologic examination showed that the damage degree of liver for rats in the trigonelline intervention group was smaller than the one in the model group, with significantly reduced hepatic steatosis and the partially visible hepatic lobule. The levels of ALT, AST, TC and LDL-C in the serum of rats in the trigonelline group were significantly reduced, while the change in the levels of TG and HDL-C was not significantly different. The levels of TG, TC and MDA in the liver tissues were significantly decreased, while the level of SOD significantly increased; the expression of Bcl-2 protein in the liver tissues of rats in the trigonelline intervention group was significantly increased, while the expression of Bax protein significantly decreased. CONCLUSIONS The trigonelline contributes to the therapeutic effect of non-alcoholic fatty liver diseases. It can also increase the expression of Bcl-2 protein and decrease the expression of Bax protein in the liver tissues, which can protect the liver.
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Affiliation(s)
- Dong-Fang Zhang
- Department of Pharmacy, Shandong Liaocheng People's Hospital, Liaocheng 252000, China.
| | - Fan Zhang
- Department of Hepatobiliary Surgery, Affiliated Hospital of Binzhou Medical University, Binzhou 256603, China
| | - Jin Zhang
- Department of Neurology, Shandong Liaocheng People's Hospital, Liaocheng 252000, China
| | - Rui-Ming Zhang
- Department of Neurology, Shandong Liaocheng People's Hospital, Liaocheng 252000, China
| | - Ran Li
- Liaocheng University, Liaocheng 252000, China
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Lu J, Fang B, Ren M, Huang G, Zhang S, Wang Y, Deng X, Guan S. Nonalcoholic fatty liver disease induced by 13-week oral administration of 1,3-dichloro-2-propanol in C57BL/6J mice. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2015; 39:1115-1121. [PMID: 25910858 DOI: 10.1016/j.etap.2015.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 03/29/2015] [Accepted: 04/04/2015] [Indexed: 06/04/2023]
Abstract
1,3-Dichloro-2-propanol (1,3-DCP) is a food born chloropropanol contaminant that has been detected during the production process of a wide range of foods. In this study, we investigated the effect of 1,3-DCP on lipid metabolism of mice after 13-week subchronic exposure. The data showed that 1,3-DCP (0.05-0.5mg/kg/day) could induce nonalcoholic fatty liver disease (NAFLD) in C57BL/6J mice and the NOAEL was 0.01mg/kg/day. In addition, we studied the signaling pathway to see how 1,3-DCP worked. The data showed that NAFLD induced by 1,3-DCP was due to the dysregulation of AMPK signaling pathway. As far as we are aware, this is the first study to use 13-week subchronic toxicology to investigate the effect of 1,3-DCP on the development of NAFLD in mice. Our study provided evidence for diet contaminants in the development of NAFLD and furthered the safety evaluation of 1,3-DCP through subchronic exposure.
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Affiliation(s)
- Jing Lu
- Department of Food Quality and Safety, Jilin University, Changchun, Jilin 130062, People's Republic of China; Key Laboratory of Zoonosis Research Ministry of Education, Jilin University, Changchun, Jilin 130062, People's Republic of China
| | - Baochen Fang
- Department of Food Quality and Safety, Jilin University, Changchun, Jilin 130062, People's Republic of China
| | - Mengrou Ren
- Department of Food Quality and Safety, Jilin University, Changchun, Jilin 130062, People's Republic of China
| | - Guoren Huang
- Department of Food Quality and Safety, Jilin University, Changchun, Jilin 130062, People's Republic of China
| | - Shuang Zhang
- Department of Food Quality and Safety, Jilin University, Changchun, Jilin 130062, People's Republic of China
| | - Yi Wang
- Department of Food Quality and Safety, Jilin University, Changchun, Jilin 130062, People's Republic of China
| | - Xuming Deng
- Key Laboratory of Zoonosis Research Ministry of Education, Jilin University, Changchun, Jilin 130062, People's Republic of China.
| | - Shuang Guan
- Department of Food Quality and Safety, Jilin University, Changchun, Jilin 130062, People's Republic of China; Key Laboratory of Zoonosis Research Ministry of Education, Jilin University, Changchun, Jilin 130062, People's Republic of China.
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