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Correlation of vitamin E, uric acid, and diet composition with histologic features of pediatric NAFLD.

Abstract

OBJECTIVES

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children in the United States. Although changes in diet are often recommended to improve NAFLD, little is known regarding the influence of diet on histologic features of the disease.

SUBJECTS AND METHODS

This was a prospective, cross-sectional registry-based study. Children (n = 149) enrolled in the multicenter nonalcoholic steatohepatitis (NASH) Clinical Research Network had demographic, anthropometric, clinical, laboratory, and histology data obtained, including the Block Brief Food Questionnaire. Subjects were grouped by presence or absence of steatohepatitis and grades of histologic features according to NASH Clinical Research Network criteria.

RESULTS

No significant differences were found between children with steatosis compared with steatohepatitis for fraction of energy from fat, carbohydrates, and protein. Sugar-sweetened beverage consumption was low and did not correlate with histologic features, although uric acid, a surrogate marker for fructose intake, was significantly increased in those with definite NASH (P = 0.008). For all groups, vitamin E consumption was insufficient compared with the recommended daily allowance. Median consumption of vitamin E was lower in children with higher grade of steatosis (8.4 vs 6.1 vs 6.9 for grades I, II, and III, respectively, P = 0.05). Those consuming less vitamin C had increased ballooning degeneration (P = 0.05).

CONCLUSIONS

Children with NAFLD have a diet that is insufficient in vitamin E and this may contribute to the pathophysiology of NAFLD. In children with NAFLD, reported sugar-sweetened beverage consumption is low; however, uric acid, which may reflect total fructose consumption, was significantly associated with NASH and should be further evaluated.

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  • Authors+Show Affiliations

    ,

    Pediatrics, Emory University, Atlanta, GA, USA.

    , , , , , , , , ,

    Source

    MeSH

    Adolescent
    Ascorbic Acid
    Child
    Cross-Sectional Studies
    Diet
    Dietary Sucrose
    Energy Intake
    Fatty Liver
    Female
    Fructose
    Humans
    Liver
    Male
    Non-alcoholic Fatty Liver Disease
    Nutrition Assessment
    Prospective Studies
    Surveys and Questionnaires
    Uric Acid
    Vitamin E
    Vitamin E Deficiency
    Vitamins

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22197855

    Citation

    Vos, Miriam B., et al. "Correlation of Vitamin E, Uric Acid, and Diet Composition With Histologic Features of Pediatric NAFLD." Journal of Pediatric Gastroenterology and Nutrition, vol. 54, no. 1, 2012, pp. 90-6.
    Vos MB, Colvin R, Belt P, et al. Correlation of vitamin E, uric acid, and diet composition with histologic features of pediatric NAFLD. J Pediatr Gastroenterol Nutr. 2012;54(1):90-6.
    Vos, M. B., Colvin, R., Belt, P., Molleston, J. P., Murray, K. F., Rosenthal, P., ... Lavine, J. E. (2012). Correlation of vitamin E, uric acid, and diet composition with histologic features of pediatric NAFLD. Journal of Pediatric Gastroenterology and Nutrition, 54(1), pp. 90-6. doi:10.1097/MPG.0b013e318229da1a.
    Vos MB, et al. Correlation of Vitamin E, Uric Acid, and Diet Composition With Histologic Features of Pediatric NAFLD. J Pediatr Gastroenterol Nutr. 2012;54(1):90-6. PubMed PMID: 22197855.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Correlation of vitamin E, uric acid, and diet composition with histologic features of pediatric NAFLD. AU - Vos,Miriam B, AU - Colvin,Ryan, AU - Belt,Patricia, AU - Molleston,Jean P, AU - Murray,Karen F, AU - Rosenthal,Philip, AU - Schwimmer,Jeffrey B, AU - Tonascia,James, AU - Unalp,Aynur, AU - Lavine,Joel E, AU - ,, PY - 2011/12/27/entrez PY - 2011/12/27/pubmed PY - 2012/5/18/medline SP - 90 EP - 6 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 54 IS - 1 N2 - OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children in the United States. Although changes in diet are often recommended to improve NAFLD, little is known regarding the influence of diet on histologic features of the disease. SUBJECTS AND METHODS: This was a prospective, cross-sectional registry-based study. Children (n = 149) enrolled in the multicenter nonalcoholic steatohepatitis (NASH) Clinical Research Network had demographic, anthropometric, clinical, laboratory, and histology data obtained, including the Block Brief Food Questionnaire. Subjects were grouped by presence or absence of steatohepatitis and grades of histologic features according to NASH Clinical Research Network criteria. RESULTS: No significant differences were found between children with steatosis compared with steatohepatitis for fraction of energy from fat, carbohydrates, and protein. Sugar-sweetened beverage consumption was low and did not correlate with histologic features, although uric acid, a surrogate marker for fructose intake, was significantly increased in those with definite NASH (P = 0.008). For all groups, vitamin E consumption was insufficient compared with the recommended daily allowance. Median consumption of vitamin E was lower in children with higher grade of steatosis (8.4 vs 6.1 vs 6.9 for grades I, II, and III, respectively, P = 0.05). Those consuming less vitamin C had increased ballooning degeneration (P = 0.05). CONCLUSIONS: Children with NAFLD have a diet that is insufficient in vitamin E and this may contribute to the pathophysiology of NAFLD. In children with NAFLD, reported sugar-sweetened beverage consumption is low; however, uric acid, which may reflect total fructose consumption, was significantly associated with NASH and should be further evaluated. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/22197855/Correlation_of_vitamin_E_uric_acid_and_diet_composition_with_histologic_features_of_pediatric_NAFLD_ L2 - http://Insights.ovid.com/pubmed?pmid=22197855 DB - PRIME DP - Unbound Medicine ER -