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eMediNexus 22 September 2020
Non-alcoholic fatty liver disease (NAFLD) is a known independent risk factor for cardiovascular disease. Among adults, histologic severity of non-alcoholic steatohepatitis (NASH) has been linked with a more atherogenic profile.
A study was recently conducted to determine the cardiovascular disease risk by lipoprotein profile among children with NAFLD and to compare to histologic assessment of severity.
Serum samples were obtained from 76 children at the time of a clinically indicated liver biopsy for NAFLD. Investigators assessed nuclear magnetic resonance lipoprotein profile including lipoprotein particle sizes, apolipoproteins and the lipoprotein insulin resistance (LP-IR) index. Liver histology was scored with the help of NASH Clinical Research Network criteria and classified as NASH or non-NASH.
Children with NASH appeared to have higher apolipoprotein B to apolipoprotein AI, ApoB/ApoAI (0.56 [IQR, 0.45-0.70] vs 0.66 [IQR, 0.56-0.79]) and higher LP-IR index (61 ± 21.9 vs 68 ± 17.3) in comparison with children with non-NASH. Severity of hepatocyte ballooning was linked with higher ApoB/ApoAI ratios. High-density lipoprotein size had an inverse association with hepatic fat accumulation.
According to the present study, severity of the histologic features has a close link with severity of cardiometabolic risk. Further studies may help understand the role of treatment of NASH in children to prevent future cardiometabolic disease.
Source: Castillo-Leon E, Connelly MA, Konomi JV, et al. Increased atherogenic lipoprotein profile in children with non-alcoholic steatohepatitis. Pediatr Obes. 2020 May 4:e12648.
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