Abstract
Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common liver disease in pediatrics. NAFLD is a chronic condition that predisposes to the development of cirrhosis and hepatocellular carcinoma. There is a strong link between NAFLD and type 2 diabetes in adults and adolescents, while some studies suggest that subjects with type 1 diabetes might be protected against the development of NAFLD. In this chapter, we review the pathophysiology and the clinical characteristics of NAFLD in pediatric groups as well as the current treatments being tested.
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References
Goldner D, Lavine JE. Nonalcoholic fatty liver disease in children: unique considerations and challenges. Gastroenterology. 2020. https://doi.org/10.1053/j.gastro.2020.01.048.
Schwimmer JB, et al. Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. J Pediatr. 2003;143:500–5. https://doi.org/10.1067/s0022-3476(03)00325-1.
Schwimmer JB, McGreal N, Deutsch R, Finegold MJ, Lavine JE. Influence of gender, race, and ethnicity on suspected fatty liver in obese adolescents. Pediatrics. 2005;115:e561–5. https://doi.org/10.1542/peds.2004-1832.
Browning JD, et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology. 2004;40:1387–95. https://doi.org/10.1002/hep.20466.
Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002;346:1221–31. https://doi.org/10.1056/NEJMra011775.
Feldstein AE, et al. The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years. Gut. 2009;58:1538–44. https://doi.org/10.1136/gut.2008.171280.
Adams LA, et al. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology. 2005;129:113–21. https://doi.org/10.1053/j.gastro.2005.04.014.
Donnelly KL, et al. Sources of fatty acids stored in liver and secreted via lipoproteins in patients with nonalcoholic fatty liver disease. J Clin Invest. 2005;115:1343–51. https://doi.org/10.1172/jci23621.
D’Adamo E, et al. Central role of fatty liver in the pathogenesis of insulin resistance in obese adolescents. Diabetes Care. 2010;33:1817–22. https://doi.org/10.2337/dc10-0284.
Lavine JE, Schwimmer JB. Pediatric initiatives within the Nonalcoholic Steatohepatitis-Clinical Research Network (NASH CNR). J Pediatr Gastroenterol Nutr. 2003;37:220–1. https://doi.org/10.1097/00005176-200309000-00002.
Newton KP, et al. Prevalence of prediabetes and type 2 diabetes in children with nonalcoholic fatty liver disease. JAMA Pediatr. 2016;170:e161971. https://doi.org/10.1001/jamapediatrics.2016.1971.
Samuel VT, Shulman GI. Nonalcoholic fatty liver disease, insulin resistance, and ceramides. N Engl J Med. 2019;381:1866–9. https://doi.org/10.1056/NEJMcibr1910023.
Kusminski CM, Scherer PE. Lowering ceramides to overcome diabetes. Science. 2019;365:319–20. https://doi.org/10.1126/science.aax6594.
Amiel SA, Sherwin RS, Simonson DC, Lauritano AA, Tamborlane WV. Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes. N Engl J Med. 1986;315:215–9. https://doi.org/10.1056/nejm198607243150402.
Trico D, et al. Metabolic features of nonalcoholic fatty liver (NAFL) in obese adolescents: findings from a multiethnic cohort. Hepatology. 2018;68:1376–90. https://doi.org/10.1002/hep.30035.
Al-Hussaini AA, Sulaiman NM, Alzahrani MD, Alenizi AS, Khan M. Prevalence of hepatopathy in type 1 diabetic children. BMC Pediatr. 2012;12:160. https://doi.org/10.1186/1471-2431-12-160.
Gaiani S, et al. Nonalcoholic fatty liver disease (NAFLD) in nonobese patients with diabetes: prevalence and relationships with hemodynamic alterations detected with Doppler sonography(). J Ultrasound. 2009;12:1–5. https://doi.org/10.1016/j.jus.2008.12.002.
Targher G, et al. Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes. J Hepatol. 2010;53:713–8. https://doi.org/10.1016/j.jhep.2010.04.030.
Targher G, et al. Nonalcoholic fatty liver disease is independently associated with an increased incidence of chronic kidney disease in patients with type 1 diabetes. Diabetes Care. 2014;37:1729–36. https://doi.org/10.2337/dc13-2704.
Li TT, et al. Prevalence and clinical characteristics of non-alcoholic fatty liver disease in newly diagnosed patients with ketosis-onset diabetes. Diabetes Metab. 2018. https://doi.org/10.1016/j.diabet.2018.03.002.
Harman DJ, et al. Prevalence and natural history of histologically proven chronic liver disease in a longitudinal cohort of patients with type 1 diabetes. Hepatology. 2014;60:158–68. https://doi.org/10.1002/hep.27098.
Cusi K, et al. Non-alcoholic fatty liver disease (NAFLD) prevalence and its metabolic associations in patients with type 1 diabetes and type 2 diabetes. Diabetes Obes Metab. 2017;19:1630–4. https://doi.org/10.1111/dom.12973.
Llaurado G, et al. Liver fat content and hepatic insulin sensitivity in overweight patients with type 1 diabetes. J Clin Endocrinol Metab. 2015;100:607–16. https://doi.org/10.1210/jc.2014-3050.
Petit JM, et al. Type 1 diabetes is not associated with an increased prevalence of hepatic steatosis. Diabet Med. 2015;32:1648–51. https://doi.org/10.1111/dme.12805.
Schwimmer JB, et al. Effect of a low free sugar diet vs usual diet on nonalcoholic fatty liver disease in adolescent boys: a randomized clinical trial. JAMA. 2019;321:256–65. https://doi.org/10.1001/jama.2018.20579.
Van Name MA, et al. A low omega-6 to omega-3 PUFA ratio (n-6:n-3 PUFA) diet to treat fatty liver disease in obese youth. J Nutr. 2020. https://doi.org/10.1093/jn/nxaa183.
Lavine JE, et al. Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents: the TONIC randomized controlled trial. JAMA. 2011;305:1659–68. https://doi.org/10.1001/jama.2011.520.
Schwimmer JB, et al. In children with nonalcoholic fatty liver disease, cysteamine bitartrate delayed release improves liver enzymes but does not reduce disease activity scores. Gastroenterology. 2016;151:1141–1154.e1149. https://doi.org/10.1053/j.gastro.2016.08.027.
Belfort R, et al. A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis. N Engl J Med. 2006;355:2297–307. https://doi.org/10.1056/NEJMoa060326.
Armstrong MJ, et al. Liraglutide safety and efficacy in patients with non-alcoholic steatohepatitis (LEAN): a multicentre, double-blind, randomised, placebo-controlled phase 2 study. Lancet. 2016;387:679–90. https://doi.org/10.1016/s0140-6736(15)00803-x.
Dong Y, et al. Efficacy and safety of glucagon-like peptide-1 receptor agonists in non-alcoholic fatty liver disease: a systematic review and meta-analysis. Clin Res Hepatol Gastroenterol. 2017;41:284–95. https://doi.org/10.1016/j.clinre.2016.11.009.
Eriksson JW, et al. Effects of dapagliflozin and n-3 carboxylic acids on non-alcoholic fatty liver disease in people with type 2 diabetes: a double-blind randomised placebo-controlled study. Diabetologia. 2018;61:1923–34. https://doi.org/10.1007/s00125-018-4675-2.
Kuchay MS, et al. Effect of empagliflozin on liver fat in patients with type 2 diabetes and nonalcoholic fatty liver disease: a randomized controlled trial (E-LIFT trial). Diabetes Care. 2018;41:1801–8. https://doi.org/10.2337/dc18-0165.
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Santoro, N., Goldberg-Gel, R., Caprio, S. (2021). Nonalcoholic Fatty Liver Disease (NAFLD) Association with Pediatric Diabetes. In: Tamborlane, W.V. (eds) Diabetes in Children and Adolescents. Contemporary Endocrinology. Humana, Cham. https://doi.org/10.1007/978-3-030-64133-7_17
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DOI: https://doi.org/10.1007/978-3-030-64133-7_17
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