BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is becoming more frequently diagnosed as the prevalence of obesity in children increases rapidly. AIM: The aim of this study was to investigate the correlation of clinical findings with histopathologic features in children with NAFLD. METHODS: 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. RESULTS: 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. CONCLUSIONS: Obesity and older age are associated with development of NASH. Type 2 NASH is the most common form and associated with a greater severity of obesity and advanced fibrosis.
BACKGROUND:Nonalcoholic fatty liver disease (NAFLD) is becoming more frequently diagnosed as the prevalence of obesity in children increases rapidly. AIM: The aim of this study was to investigate the correlation of clinical findings with histopathologic features in children with NAFLD. METHODS: 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. RESULTS: 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. CONCLUSIONS:Obesity and older age are associated with development of NASH. Type 2 NASH is the most common form and associated with a greater severity of obesity and advanced fibrosis.
Authors: C García-Monzón; E Martín-Pérez; O L Iacono; M Fernández-Bermejo; P L Majano; A Apolinario; E Larrañaga; R Moreno-Otero Journal: J Hepatol Date: 2000-11 Impact factor: 25.083
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Authors: Jeffrey B Schwimmer; Reena Deutsch; Jeffrey B Rauch; Cynthia Behling; Robert Newbury; Joel E Lavine Journal: J Pediatr Date: 2003-10 Impact factor: 4.406
Authors: Jennifer L Rehm; Ellen L Connor; Peter M Wolfgram; Jens C Eickhoff; Scott B Reeder; David B Allen Journal: J Pediatr Date: 2014-05-22 Impact factor: 4.406
Authors: Jeffrey B Schwimmer; Cynthia Behling; Jorge Eduardo Angeles; Melissa Paiz; Janis Durelle; Jonathan Africa; Kimberly P Newton; Elizabeth M Brunt; Joel E Lavine; Stephanie H Abrams; Prakash Masand; Rajesh Krishnamurthy; Kelvin Wong; Richard L Ehman; Meng Yin; Kevin J Glaser; Bogdan Dzyubak; Tanya Wolfson; Anthony C Gamst; Jonathan Hooker; William Haufe; Alexandra Schlein; Gavin Hamilton; Michael S Middleton; Claude B Sirlin Journal: Hepatology Date: 2017-10-09 Impact factor: 17.425
Authors: Elvira Verduci; Carlo Pozzato; Giuseppe Banderali; Giovanni Radaelli; Chiara Arrizza; Antonio Rovere; Enrica Riva; Marcello Giovannini Journal: World J Hepatol Date: 2013-09-27
Authors: Jennifer L Rehm; Peter M Wolfgram; Diego Hernando; Jens C Eickhoff; David B Allen; Scott B Reeder Journal: Eur Radiol Date: 2015-04-28 Impact factor: 5.315