NAFLD in children: A prospective clinical-pathological study and effect of lifestyle advice

Valerie Nobili, Matilde Marcellini, Rita Devito, Paolo Ciampalini, Fiorella Piemonte, Donatella Comparcola, Maria Rita Sartorelli, Paul Angulo

Research output: Contribution to journalArticle

256 Citations (Scopus)

Abstract

Nonalcoholic fatty liver disease (NAFLD), a common cause of chronic liver disease in adults, is incompletely characterized in children. We conducted a prospective study to better characterize the clinical presentation of NAFLD in children and to determine the effect of lifestyle advice in the management of pediatric NAFLD. From June 2001 to April 2003, 84 children (age 3-18.8 yr) who had elevated aminotransferases and the diagnosis of NAFLD confirmed via liver biopsy underwent a 2-hour oral glucose tolerance test and a 12-month program of lifestyle advice consisting of diet and physical exercise. Thirty-four (40.5%) patients were obese (body mass index [BMI] >97th percentile), and 43 (51.2%) were overweight (BMI 85th-97th percentile). Ten (12%) had abnormal glucose tolerance; 10 (12%) had elevated triglycerides, cholesterol, or both; and all had normal blood pressure. Most children (67/84, 80%) were insulin-resistant, including the 7 children with normal BMI (th percentile). Increased liver fibrosis was present in 49 (58.1%) patients and was independently associated with obesity (OR 2.7, 95% CI 1.2-6.2) and age (1-year increase; OR 1.2, 95% CI 1.04-1.5). A 12-month program with diet and physical exercise resulted in a significant decrease in BMI, and levels of fasting glucose, insulin, lipids, and liver enzymes, as well as liver echogenicity on ultrasonography. In conclusion, children with NAFLD are almost always insulin-resistant regardless of BML Obesity and older age are independently associated with increased liver fibrosis. A simple lifestyle advice program significantly improves insulin resistance, and the liver disease in pediatric NAFLD.

Original languageEnglish
Pages (from-to)458-465
Number of pages8
JournalHepatology
Volume44
Issue number2
DOIs
Publication statusPublished - Aug 2006

Fingerprint

Life Style
Body Mass Index
Insulin
Liver Cirrhosis
Liver Diseases
Liver
Obesity
Exercise
Pediatrics
Diet
Glucose
Glucose Tolerance Test
Transaminases
Hypercholesterolemia
Insulin Resistance
Non-alcoholic Fatty Liver Disease
Clinical Studies
Fasting
Ultrasonography
Triglycerides

ASJC Scopus subject areas

  • Hepatology

Cite this

NAFLD in children : A prospective clinical-pathological study and effect of lifestyle advice. / Nobili, Valerie; Marcellini, Matilde; Devito, Rita; Ciampalini, Paolo; Piemonte, Fiorella; Comparcola, Donatella; Sartorelli, Maria Rita; Angulo, Paul.

In: Hepatology, Vol. 44, No. 2, 08.2006, p. 458-465.

Research output: Contribution to journalArticle

Nobili, Valerie ; Marcellini, Matilde ; Devito, Rita ; Ciampalini, Paolo ; Piemonte, Fiorella ; Comparcola, Donatella ; Sartorelli, Maria Rita ; Angulo, Paul. / NAFLD in children : A prospective clinical-pathological study and effect of lifestyle advice. In: Hepatology. 2006 ; Vol. 44, No. 2. pp. 458-465.
@article{34fc0766130147c58e641acea85d0db6,
title = "NAFLD in children: A prospective clinical-pathological study and effect of lifestyle advice",
abstract = "Nonalcoholic fatty liver disease (NAFLD), a common cause of chronic liver disease in adults, is incompletely characterized in children. We conducted a prospective study to better characterize the clinical presentation of NAFLD in children and to determine the effect of lifestyle advice in the management of pediatric NAFLD. From June 2001 to April 2003, 84 children (age 3-18.8 yr) who had elevated aminotransferases and the diagnosis of NAFLD confirmed via liver biopsy underwent a 2-hour oral glucose tolerance test and a 12-month program of lifestyle advice consisting of diet and physical exercise. Thirty-four (40.5{\%}) patients were obese (body mass index [BMI] >97th percentile), and 43 (51.2{\%}) were overweight (BMI 85th-97th percentile). Ten (12{\%}) had abnormal glucose tolerance; 10 (12{\%}) had elevated triglycerides, cholesterol, or both; and all had normal blood pressure. Most children (67/84, 80{\%}) were insulin-resistant, including the 7 children with normal BMI (th percentile). Increased liver fibrosis was present in 49 (58.1{\%}) patients and was independently associated with obesity (OR 2.7, 95{\%} CI 1.2-6.2) and age (1-year increase; OR 1.2, 95{\%} CI 1.04-1.5). A 12-month program with diet and physical exercise resulted in a significant decrease in BMI, and levels of fasting glucose, insulin, lipids, and liver enzymes, as well as liver echogenicity on ultrasonography. In conclusion, children with NAFLD are almost always insulin-resistant regardless of BML Obesity and older age are independently associated with increased liver fibrosis. A simple lifestyle advice program significantly improves insulin resistance, and the liver disease in pediatric NAFLD.",
author = "Valerie Nobili and Matilde Marcellini and Rita Devito and Paolo Ciampalini and Fiorella Piemonte and Donatella Comparcola and Sartorelli, {Maria Rita} and Paul Angulo",
year = "2006",
month = "8",
doi = "10.1002/hep.21262",
language = "English",
volume = "44",
pages = "458--465",
journal = "Hepatology",
issn = "0270-9139",
publisher = "John Wiley and Sons Inc.",
number = "2",

}

TY - JOUR

T1 - NAFLD in children

T2 - A prospective clinical-pathological study and effect of lifestyle advice

AU - Nobili, Valerie

AU - Marcellini, Matilde

AU - Devito, Rita

AU - Ciampalini, Paolo

AU - Piemonte, Fiorella

AU - Comparcola, Donatella

AU - Sartorelli, Maria Rita

AU - Angulo, Paul

PY - 2006/8

Y1 - 2006/8

N2 - Nonalcoholic fatty liver disease (NAFLD), a common cause of chronic liver disease in adults, is incompletely characterized in children. We conducted a prospective study to better characterize the clinical presentation of NAFLD in children and to determine the effect of lifestyle advice in the management of pediatric NAFLD. From June 2001 to April 2003, 84 children (age 3-18.8 yr) who had elevated aminotransferases and the diagnosis of NAFLD confirmed via liver biopsy underwent a 2-hour oral glucose tolerance test and a 12-month program of lifestyle advice consisting of diet and physical exercise. Thirty-four (40.5%) patients were obese (body mass index [BMI] >97th percentile), and 43 (51.2%) were overweight (BMI 85th-97th percentile). Ten (12%) had abnormal glucose tolerance; 10 (12%) had elevated triglycerides, cholesterol, or both; and all had normal blood pressure. Most children (67/84, 80%) were insulin-resistant, including the 7 children with normal BMI (th percentile). Increased liver fibrosis was present in 49 (58.1%) patients and was independently associated with obesity (OR 2.7, 95% CI 1.2-6.2) and age (1-year increase; OR 1.2, 95% CI 1.04-1.5). A 12-month program with diet and physical exercise resulted in a significant decrease in BMI, and levels of fasting glucose, insulin, lipids, and liver enzymes, as well as liver echogenicity on ultrasonography. In conclusion, children with NAFLD are almost always insulin-resistant regardless of BML Obesity and older age are independently associated with increased liver fibrosis. A simple lifestyle advice program significantly improves insulin resistance, and the liver disease in pediatric NAFLD.

AB - Nonalcoholic fatty liver disease (NAFLD), a common cause of chronic liver disease in adults, is incompletely characterized in children. We conducted a prospective study to better characterize the clinical presentation of NAFLD in children and to determine the effect of lifestyle advice in the management of pediatric NAFLD. From June 2001 to April 2003, 84 children (age 3-18.8 yr) who had elevated aminotransferases and the diagnosis of NAFLD confirmed via liver biopsy underwent a 2-hour oral glucose tolerance test and a 12-month program of lifestyle advice consisting of diet and physical exercise. Thirty-four (40.5%) patients were obese (body mass index [BMI] >97th percentile), and 43 (51.2%) were overweight (BMI 85th-97th percentile). Ten (12%) had abnormal glucose tolerance; 10 (12%) had elevated triglycerides, cholesterol, or both; and all had normal blood pressure. Most children (67/84, 80%) were insulin-resistant, including the 7 children with normal BMI (th percentile). Increased liver fibrosis was present in 49 (58.1%) patients and was independently associated with obesity (OR 2.7, 95% CI 1.2-6.2) and age (1-year increase; OR 1.2, 95% CI 1.04-1.5). A 12-month program with diet and physical exercise resulted in a significant decrease in BMI, and levels of fasting glucose, insulin, lipids, and liver enzymes, as well as liver echogenicity on ultrasonography. In conclusion, children with NAFLD are almost always insulin-resistant regardless of BML Obesity and older age are independently associated with increased liver fibrosis. A simple lifestyle advice program significantly improves insulin resistance, and the liver disease in pediatric NAFLD.

UR - http://www.scopus.com/inward/record.url?scp=33747077203&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33747077203&partnerID=8YFLogxK

U2 - 10.1002/hep.21262

DO - 10.1002/hep.21262

M3 - Article

C2 - 16871574

AN - SCOPUS:33747077203

VL - 44

SP - 458

EP - 465

JO - Hepatology

JF - Hepatology

SN - 0270-9139

IS - 2

ER -