Liver Update: Progression of Fatty Liver Disease in Children Receiving Standard of Care Lifestyle Advice |

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Liver Update: Progression of Fatty Liver Disease in Children Receiving Standard of Care Lifestyle Advice

eMediNexus, 08 September 2021
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#Gastroenterology #Hepatology #Multispeciality

The most frequent pediatric chronic liver disease is Nonalcoholic fatty liver disease (NAFLD). But its outcomes in recognized youth are unclear.A study compared paired liver biopsies from children with NAFLD, receiving placebo and standard of care lifestyle advice in 2 double-blind, randomized clinical trials. The histological changes from baseline and longitudinal change in clinical variables using regression analysis were assessed.The results found that-During enrollment-31% of the child...

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Liver Update: Progression of Fatty Liver Disease in Children Receiving Standard of Care Lifestyle Advice

eMediNexus, 08 September 2021
#Gastroenterology #Hepatology #Multispeciality

The most frequent pediatric chronic liver disease is Nonalcoholic fatty liver disease (NAFLD). But its outcomes in recognized youth are unclear.

A study compared paired liver biopsies from children with NAFLD, receiving placebo and standard of care lifestyle advice in 2 double-blind, randomized clinical trials. The histological changes from baseline and longitudinal change in clinical variables using regression analysis were assessed.

The results found that-

During enrollment-

31% of the children had definite NASH,
34% had borderline zone 1 NASH,
13% had borderline zone 3 NASH,
21% had fatty liver but not NASH.

After 1.6 ± 0.4 years (mean)-

29% of the children showed resolution of borderline or definite NASH 18% of the children with fatty liver or borderline NASH developed definite NASH.
34% of the children demonstrated an improvement in Fibrosis
23% of the children demonstrated worsening of Fibrosis.
At baseline, any progression to definite NASH and/or fibrosis was related to adolescent age, and higher waist circumference, levels of alanine or aspartate aminotransferase, total and low-density lipoprotein cholesterol.
Over follow-up time, any progression to definite NASH and/or in fibrosis was related to an increasing level of alanine aminotransferase, haemoglobin A1C.

Reduced odds of any improvement was noted with an increasing level of gamma-glutamyl transferase

Thus it was concluded that 33% of children with NAFLD enrolled in placebo groups of clinical trials demonstrates histologic features of progression within 2 years, with increasing obesity and serum levels of aminotransferases and loss of glucose homeostasis.

Source: Gastroenterology. 2020 Nov;159(5):1731-1751.e10. doi: 10.1053/j.gastro.2020.07.034. Epub 2020 Jul 23. PMID: 32712103; PMCID: PMC7680281.

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