Clinical and Histological Features of Nonalcoholic Fatty Liver Disease in Children
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Nonalcoholic fatty liver disease (NAFLD) is becoming more frequently diagnosed as the prevalence of obesity in children increases rapidly.
The aim of this study was to investigate the correlation of clinical findings with histopathologic features in children with NAFLD.
We reviewed the clinical data and liver histology results of children with biopsy-proven NAFLD at Seoul National University Hospital. NAFLD was classified as simple steatosis, type 1 nonalcoholic steatohepatitis (NASH), characterized by ballooning degeneration and perisinusoidal fibrosis, or type 2 NASH, characterized by portal inflammation and portal fibrosis.
Among 80 total patients, 84% were male. All patients were obese or overweight. Insulin resistance was present in 96% of children. Perisinusoidal fibrosis was noted in 45% of children and portal fibrosis was noted in 77%. Simple steatosis was present in 22% of children, type 1 NASH in 34%, and type 2 NASH in 44%. No differences were found among NAFLD subtypes or NAFLD activity score with regard to sex, blood pressure, or levels of aminotransferase, fasting lipid, or insulin. Children with NASH were older and had higher body mass index than those with simple steatosis. Patients with type 2 NASH had higher body mass index and advanced fibrosis compared with patients with type 1 NASH.
- Hubscher SG. Histological assessment of non-alcoholic fatty liver disease. Histopathology. 2006;49:450–465. CrossRef
- Schwimmer JB, Deutsch R, Kahen T, et al. Prevalence of fatty liver in children and adolescents. Pediatrics. 2006;118:1388–1393. CrossRef
- Tominaga K, Kurata JH, Chen YK, et al. Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey. Dig Dis Sci. 1995;40:2002–2009. CrossRef
- Park HS, Han JH, Choi KM, et al. Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean children. Am J Clin Nutr. 2005;82:1046–1051.
- Papandreou D, Rousso I, Mavromichalis I. Update on non-alcoholic fatty liver disease in children. Clin Nutr. 2007;26:409–415. CrossRef
- Ludwig J, Viggiano TR, McGill DB, et al. Nonalcoholic steatohepatitis: Mayo clinic experiences with a hitherto unnamed disease. Mayo Clin Proc. 1980;55:434–438.
- Brunt EM, Janney CG, Di Bisceglie AM, et al. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol. 1999;94:2467–2474. CrossRef
- Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41:1313–1321. CrossRef
- Schwimmer JB, Behling C, Newbury R, et al. Histopathology of pediatric nonalcoholic fatty liver disease. Hepatology. 2005;42:641–649. CrossRef
- Moon JS, Nam CM, Choi JM, et al. 2007 Korean national growth charts: review of developmental process and an outlook. Korean J Pediatr. 2008;51:1–25. CrossRef
- Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–419. CrossRef
- Skelly MM, James PD, Ryder SD. Findings on liver biopsy to investigate abnormal liver function tests in the absence of diagnostic serology. J Hepatol. 2001;35:195–199. CrossRef
- de Ledinghen V, Combes M, Trouette H, et al. Should a liver biopsy be done in patients with subclinical chronically elevated transaminases? Eur J Gastroenterol Hepatol. 2004;16:879–883. CrossRef
- Caldwell SH, Oelsner DH, Iezzoni JC, et al. Cryptogenic cirrhosis: clinical characterization and risk factors for underlying disease. Hepatology. 1999;29:664–669. CrossRef
- McCullough AJ. The clinical features, diagnosis and natural history of nonalcoholic fatty liver disease. Clin Liver Dis. 2004;8:521–533. CrossRef
- Nobili V, Marcellini M, Devito R, et al. NAFLD in children: a prospective clinical-pathological study and effect of lifestyle advice. Hepatology. 2006;44:458–465. CrossRef
- Patton HM, Lavine JE, Van Natta ML, et al. Clinical correlates of histopathology in pediatric nonalcoholic steatohepatitis. Gastroenterology. 2008;135:1961–1971. CrossRef
- Chitturi S, Abeygunasekera S, Farrell GC, et al. NASH and insulin resistance: insulin hypersecretion and specific association with the insulin resistance syndrome. Hepatology. 2002;35:373–379. CrossRef
- Garcia-Monzon C, Martin-Perez E, Iacono OL, et al. Characterization of pathogenic and prognostic factors of nonalcoholic steatohepatitis associated with obesity. J Hepatol. 2000;33:716–724. CrossRef
- Schwimmer JB, Deutsch R, Rauch JB, et al. Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. J Pediatr. 2003;143:500–505. CrossRef
- Clinical and Histological Features of Nonalcoholic Fatty Liver Disease in Children
Digestive Diseases and Sciences
Volume 54, Issue 10 , pp 2225-2230
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Fatty liver disease
- Industry Sectors
- Author Affiliations
- 1. Department of Pediatrics, Seoul National University College of Medicine, 28 Yongondong, Jongrogu, Seoul, 110-744, Korea
- 2. Department of Pathology, Seoul National University College of Medicine, 28 Yongondong, Jongrogu, Seoul, Korea
- 3. Department of Radiology, Seoul National University College of Medicine, 28 Yongondong, Jongrogu, Seoul, Korea