학술논문
Progression of Fatty Liver Disease in Children Receiving Standard of Care Lifestyle Advice
Document Type
article
Author
Xanthakos, Stavra A; Lavine, Joel E; Yates, Katherine P; Schwimmer, Jeffrey B; Molleston, Jean P; Rosenthal, Philip; Murray, Karen F; Vos, Miriam B; Jain, Ajay K; Scheimann, Ann O; Miloh, Tamir; Fishbein, Mark; Behling, Cynthia A; Brunt, Elizabeth M; Sanyal, Arun J; Tonascia, James; Abrams, Stephanie; Garner, Donna; Hertel, Paula; Himes, Ryan; Lawson, Alicia; Triggs, Nicole; Bramlage, Kristin; Carr, April; Cecil, Kim; McNeill, Meghan; Mouzaki, Marialena; Trout, Andrew; Xanthakos, Stavra; Bernstein, Kimberlee; DeVore, Stephanie; Kohli, Rohit; Lake, Kathleen; Podberesky, Daniel; Towbin, Alex; Mencin, Ali; Reynoso, Elena; Alazraki, Adina; Cleeton, Rebecca; Cordero, Maria; Hernandez, Albert; Karpen, Saul; Munos, Jessica Cruz; Raviele, Nicholas; Vos, Miriam; Bozic, Molly; Carr, Laura; Cummings, Oscar W; Harlow, Kathryn; Klipsch, Ann; Ragozzino, Emily; Rao, Girish; Kafka, Kimberly; Scheimann, Ann; Fishbein, Mark H; Ito, Joy; Mohammad, Saeed; Whitington, Peter F; Barlow, Sarah; Carpenter, Danielle; Cattoor, Theresa; Derdoy, Jose; Freebersyser, Janet; Jain, Ajay; King, Debra; Lai, Jinping; Siegner, Joan; Stewart, Susan; Torretta, Susan; Wriston, Kristina; Angeles, Jorge; Arin, Jennifer; Behling, Cynthia; Bross, Craig; Carrier, Carissa; Collins, Jennifer; De La Pena, Diana; Durelle, Janis; Huckaby, Mary Catherine; Middleton, Michael S; Newton, Kimberly; Sirlin, Claude; Ugalde-Nicalo, Patricia; Courtier, Jesse; Gill, Ryan; Langlois, Camille; Perito, Emily Rothbaum; Tsai, Patrika; Blondet, Niviann; Cooper, Kara; Murray, Karen; Otto, Randolph; Yeh, Matthew
Source
Gastroenterology. 159(5)
Subject
Language
Abstract
Background & aimsNonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease. Little is known about outcomes in recognized youth.MethodsWe compared paired liver biopsies from 122 of 139 children with NAFLD (74% male; 64% white; 71% Hispanic; mean age, 13 ± 3 years; age range, 8-17 years) who received placebo and standard of care lifestyle advice in 2 double-blind, randomized clinical trials within the nonalcoholic steatohepatitis (NASH) clinical research network from 2005 through 2015. We analyzed histologic changes with respect to baseline and longitudinal change in clinical variables using regression analysis.ResultsAt enrollment, 31% of the children had definite NASH, 34% had borderline zone 1 NASH, 13% had borderline zone 3 NASH, and 21% had fatty liver but not NASH. Over a mean period of 1.6 ± 0.4 years, borderline or definite NASH resolved in 29% of the children, whereas 18% of the children with fatty liver or borderline NASH developed definite NASH. Fibrosis improved in 34% of the children but worsened in 23%. Any progression to definite NASH and/or in fibrosis was associated with adolescent age, and higher waist circumference, levels of alanine or aspartate aminotransferase, total and low-density lipoprotein cholesterol at baseline (