Tags

Type your tag names separated by a space and hit enter

Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents.
J Hepatol 2017; 66(5):1031-1036JH

Abstract

BACKGROUND & AIMS

Recent research has suggested that dietary fructose intake may increase serum uric acid (UA) concentrations. Both UA concentration and fructose consumption maybe also increase in NAFLD. It is not known whether dietary fructose consumption and UA concentration are independently associated with non-alcoholic steatohepatitis (NASH). Our aim was to investigate the factors associated with NASH in children and adolescents with proven NAFLD, and to test whether UA concentrations and fructose consumption are independently associated with NASH.

METHODS

Obese children with NAFLD were studied (n=271). NASH was diagnosed by a NAFLD activity score ⩾5 and the fatty liver inhibition of progression (FLIP) algorithm. Fructose consumption (g/day) was assessed by food frequency questionnaire, and UA (mg/dl) was measured in serum. Binary logistic regression with adjustment for covariates and potential confounders was undertaken to test factors independently associated with NASH.

RESULTS

NASH occurred in 37.6% of patients. Hyperuricaemia (UA ⩾5.9mg/dl) was present in 47% of patients with NASH compared with 29.7% of non-NASH patients (p=0.003). Both UA concentration (OR=2.488, 95% CI: 1.87-2.83, p=0.004) and fructose consumption (OR=1.612, 95% CI 1.25-1.86, p=0.001) were independently associated with NASH, after adjustment for multiple (and all) measured confounders. Fructose consumption was independently associated with hyperuricaemia (OR=2.021, 95% CI: 1.66-2.78, p=0.01). These data were confirmed using the FLIP algorithm.

CONCLUSIONS

Both dietary fructose consumption and serum UA concentrations are independently associated with NASH. Fructose consumption was the only factor independently associated with serum UA concentration.

LAY SUMMARY

Currently, it is not known whether dietary fructose consumption and uric acid (UA) concentration are linked with non-alcoholic steatohepatitis (NASH) in children and adolescents. Our aim was to test whether UA concentrations and fructose consumption are independently associated with NASH in children and adolescents with proven non-alcoholic fatty liver disease (NAFLD). We show that both dietary fructose consumption and serum UA concentrations are independently associated with NASH and fructose consumption was independently linked with high serum UA concentrations.

Authors+Show Affiliations

Hepatometabolic Unit - Bambino Gesù Children's Hospital, Rome, Italy.Hepatometabolic Unit - Bambino Gesù Children's Hospital, Rome, Italy; Histopathology Unit, Bambino Gesù Hospital, IRCCS, Rome, Italy. Electronic address: nobili66@yahoo.it.Histopathology Unit, Bambino Gesù Hospital, IRCCS, Rome, Italy.Liver Research Unit - Bambino Gesù Children's Hospital, Rome, Italy.Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom.Paediatrics and Infectious Disease, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.Liver Research Unit - Bambino Gesù Children's Hospital, Rome, Italy.Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28214020

Citation

Mosca, Antonella, et al. "Serum Uric Acid Concentrations and Fructose Consumption Are Independently Associated With NASH in Children and Adolescents." Journal of Hepatology, vol. 66, no. 5, 2017, pp. 1031-1036.
Mosca A, Nobili V, De Vito R, et al. Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents. J Hepatol. 2017;66(5):1031-1036.
Mosca, A., Nobili, V., De Vito, R., Crudele, A., Scorletti, E., Villani, A., ... Byrne, C. D. (2017). Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents. Journal of Hepatology, 66(5), pp. 1031-1036. doi:10.1016/j.jhep.2016.12.025.
Mosca A, et al. Serum Uric Acid Concentrations and Fructose Consumption Are Independently Associated With NASH in Children and Adolescents. J Hepatol. 2017;66(5):1031-1036. PubMed PMID: 28214020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents. AU - Mosca,Antonella, AU - Nobili,Valerio, AU - De Vito,Rita, AU - Crudele,Annalisa, AU - Scorletti,Eleonora, AU - Villani,Alberto, AU - Alisi,Anna, AU - Byrne,Christopher D, Y1 - 2017/02/14/ PY - 2016/10/13/received PY - 2016/12/01/revised PY - 2016/12/28/accepted PY - 2017/2/19/pubmed PY - 2017/10/25/medline PY - 2017/2/19/entrez KW - Adolescent KW - Child KW - Diet KW - Fructose KW - Fructose consumption KW - Hyperuricemia KW - Non-alcoholic fatty liver disease (NAFLD) KW - Non-alcoholic steatohepatitis (NASH) KW - Obesity KW - Uric acid SP - 1031 EP - 1036 JF - Journal of hepatology JO - J. Hepatol. VL - 66 IS - 5 N2 - BACKGROUND & AIMS: Recent research has suggested that dietary fructose intake may increase serum uric acid (UA) concentrations. Both UA concentration and fructose consumption maybe also increase in NAFLD. It is not known whether dietary fructose consumption and UA concentration are independently associated with non-alcoholic steatohepatitis (NASH). Our aim was to investigate the factors associated with NASH in children and adolescents with proven NAFLD, and to test whether UA concentrations and fructose consumption are independently associated with NASH. METHODS: Obese children with NAFLD were studied (n=271). NASH was diagnosed by a NAFLD activity score ⩾5 and the fatty liver inhibition of progression (FLIP) algorithm. Fructose consumption (g/day) was assessed by food frequency questionnaire, and UA (mg/dl) was measured in serum. Binary logistic regression with adjustment for covariates and potential confounders was undertaken to test factors independently associated with NASH. RESULTS: NASH occurred in 37.6% of patients. Hyperuricaemia (UA ⩾5.9mg/dl) was present in 47% of patients with NASH compared with 29.7% of non-NASH patients (p=0.003). Both UA concentration (OR=2.488, 95% CI: 1.87-2.83, p=0.004) and fructose consumption (OR=1.612, 95% CI 1.25-1.86, p=0.001) were independently associated with NASH, after adjustment for multiple (and all) measured confounders. Fructose consumption was independently associated with hyperuricaemia (OR=2.021, 95% CI: 1.66-2.78, p=0.01). These data were confirmed using the FLIP algorithm. CONCLUSIONS: Both dietary fructose consumption and serum UA concentrations are independently associated with NASH. Fructose consumption was the only factor independently associated with serum UA concentration. LAY SUMMARY: Currently, it is not known whether dietary fructose consumption and uric acid (UA) concentration are linked with non-alcoholic steatohepatitis (NASH) in children and adolescents. Our aim was to test whether UA concentrations and fructose consumption are independently associated with NASH in children and adolescents with proven non-alcoholic fatty liver disease (NAFLD). We show that both dietary fructose consumption and serum UA concentrations are independently associated with NASH and fructose consumption was independently linked with high serum UA concentrations. SN - 1600-0641 UR - https://www.unboundmedicine.com/medline/citation/28214020/Serum_uric_acid_concentrations_and_fructose_consumption_are_independently_associated_with_NASH_in_children_and_adolescents_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8278(17)30002-8 DB - PRIME DP - Unbound Medicine ER -