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Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease.
J Pediatr. 2003 Oct; 143(4):500-5.JPed

Abstract

OBJECTIVE

To describe the clinical characteristics of nonalcoholic fatty liver disease (NAFLD) in children, including insulin resistance, and to test for correlation with liver pathology.

STUDY DESIGN

A retrospective review of children with biopsy-proven NAFLD at Children's Hospital San Diego from 1999 to 2002. Liver biopsy specimens were independently reviewed by two pathologists.

RESULTS

Children with NAFLD (n=43) were mostly male (70%), Hispanic American (53%) and obese (88%). The criteria for insulin resistance were met by 95% of subjects. Steatosis was predicted by the combination of quantitative insulin sensitivity check index, age, and ethnicity (P<.0001). Portal inflammation was predicted by the combination of ALT and fasting insulin (P=.0009). Perisinusoidal fibrosis was predicted by the combination of AST, fasting insulin, and BMI Z score (P<.0001). Portal fibrosis was predicted by the combination of right upper quadrant pain and homeostasis model assessment of insulin resistance (P=.0028).

CONCLUSIONS

We identified significant predictors of liver pathology in children with NAFLD. Children being evaluated for NAFLD should be screened for insulin resistance, which is nearly universal and correlates with liver histology.

Authors+Show Affiliations

Joint Program in Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Family and Preventive Medicine, Department of Pathology, the School of Medicine, University of California-San Diego, 200 West Arbor Drive, San Diego, CA 92103, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14571229

Citation

Schwimmer, Jeffrey B., et al. "Obesity, Insulin Resistance, and Other Clinicopathological Correlates of Pediatric Nonalcoholic Fatty Liver Disease." The Journal of Pediatrics, vol. 143, no. 4, 2003, pp. 500-5.
Schwimmer JB, Deutsch R, Rauch JB, et al. Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. J Pediatr. 2003;143(4):500-5.
Schwimmer, J. B., Deutsch, R., Rauch, J. B., Behling, C., Newbury, R., & Lavine, J. E. (2003). Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. The Journal of Pediatrics, 143(4), 500-5.
Schwimmer JB, et al. Obesity, Insulin Resistance, and Other Clinicopathological Correlates of Pediatric Nonalcoholic Fatty Liver Disease. J Pediatr. 2003;143(4):500-5. PubMed PMID: 14571229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. AU - Schwimmer,Jeffrey B, AU - Deutsch,Reena, AU - Rauch,Jeffrey B, AU - Behling,Cynthia, AU - Newbury,Robert, AU - Lavine,Joel E, PY - 2003/10/23/pubmed PY - 2003/12/3/medline PY - 2003/10/23/entrez SP - 500 EP - 5 JF - The Journal of pediatrics JO - J Pediatr VL - 143 IS - 4 N2 - OBJECTIVE: To describe the clinical characteristics of nonalcoholic fatty liver disease (NAFLD) in children, including insulin resistance, and to test for correlation with liver pathology. STUDY DESIGN: A retrospective review of children with biopsy-proven NAFLD at Children's Hospital San Diego from 1999 to 2002. Liver biopsy specimens were independently reviewed by two pathologists. RESULTS: Children with NAFLD (n=43) were mostly male (70%), Hispanic American (53%) and obese (88%). The criteria for insulin resistance were met by 95% of subjects. Steatosis was predicted by the combination of quantitative insulin sensitivity check index, age, and ethnicity (P<.0001). Portal inflammation was predicted by the combination of ALT and fasting insulin (P=.0009). Perisinusoidal fibrosis was predicted by the combination of AST, fasting insulin, and BMI Z score (P<.0001). Portal fibrosis was predicted by the combination of right upper quadrant pain and homeostasis model assessment of insulin resistance (P=.0028). CONCLUSIONS: We identified significant predictors of liver pathology in children with NAFLD. Children being evaluated for NAFLD should be screened for insulin resistance, which is nearly universal and correlates with liver histology. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/14571229/Obesity_insulin_resistance_and_other_clinicopathological_correlates_of_pediatric_nonalcoholic_fatty_liver_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(03)00325-1 DB - PRIME DP - Unbound Medicine ER -