Research Article Details
| Article ID: | A27004 |
| PMID: | 19366381 |
| Source: | J Am Acad Nurse Pract |
| Title: | Fatty liver in adolescents on the U.S.-Mexico border. |
| Abstract: | PURPOSE: To describe the physical and metabolic characteristics of children diagnosed with fatty liver disease in a gastroenterology clinic in El Paso, Texas. DATA SOURCES: A retrospective chart review of 31 patients aged 8-18 diagnosed with fatty liver was conducted. CONCLUSIONS: These children were diagnosed with fatty liver by elevated alanine aminotransferase (ALT) levels (mean ALT levels 126 +/- 08 U/L) and increased hepatic echogenicity measured via ultrasound. The majority of children were adolescents (12-17 years of age) and Mexican American. All subjects were overweight (body mass index [BMI] > or = 95th percentile) based on Centers for Disease Control and Prevention standards. In a subset of children for whom results from laboratory test were available, we found 40% had high triglycerides (> or = 150 mg/dL), 53% had low high-density lipoprotein cholesterol (< or = 35 mg/dL), and 17% had prediabetes (fasting glucose > or = 100 mg/dL). The clinical and laboratory findings in this patient population with fatty liver are consistent with a diagnosis of nonalcoholic fatty liver disease (NAFLD). IMPLICATIONS FOR PRACTICE: Despite the increasing trend in overweight among children and adolescents, data suggest low rates of diagnosis and management of overweight and related comorbidities by healthcare providers. Overweight has been associated with fatty liver disease in the pediatric population and includes other comorbidities such insulin resistance and features of metabolic syndrome. Screening for overweight in children should constitute the first step in identifying children at risk for NAFLD. Nurse practitioners should include in the evaluation of pediatric patients calculation of BMI and waist circumference for age and screening for other overweight-related comorbidities. |
| DOI: | 10.1111/j.1745-7599.2009.00397.x |
| Strategy ID | Therapy Strategy | Synonyms | Therapy Targets | Therapy Drugs | |
|---|---|---|---|---|---|
| S01 | Improve insulin resistance | insulin sensitizer; insulin resistance; glucose tolerance | Biguanide: increases 5-AMP activated protein kinase signaling; SGLT-2 inhibitor; Thiazalidinedione: selective PPAR-γ agonists; GLP-1 agonist | Metformin; Empagliflozin; Canagliflozin; Rosiglitazone; Pioglitazone; Liraglutide | Details |
| Diseases ID | DO ID | Disease Name | Definition | Class | |
|---|---|---|---|---|---|
| I05 | 9352 | Type 2 diabetes mellitus | A diabetes that is characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. A diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. http://en.wikipedia.org/wiki/Diabetes, http://en.wikipedia.org/wiki/Diabetes_mellitus_type_2 | disease of metabolism/inherited metabolic disorder/ carbohydrate metabolic disorder/glucose metabolism disease/diabetes/ diabetes mellitus | Details |
| I14 | 9970 | Obesity | An overnutrition that is characterized by excess body fat, traditionally defined as an elevated ratio of weight to height (specifically 30 kilograms per meter squared), has_material_basis_in a multifactorial etiology related to excess nutrition intake, decreased caloric utilization, and genetic susceptibility, and possibly medications and certain disorders of metabolism, endocrine function, and mental illness. https://en.wikipedia.org/wiki/Obesity | disease of metabolism/acquired metabolic disease/ nutrition disease/overnutrition | Details |
| Drug ID | Drug Name | Type | DrugBank ID | Targets | Category | Latest Progress | |
|---|---|---|---|---|---|---|---|
| D199 | L-alanine | Chemical drug | DB00160 | KYNU | -- | Failed in clinical trials | Details |
| D080 | Citrulline | Chemical drug | DB00155 | -- | -- | Under clinical trials | Details |
| D182 | Insulin | Biological drug | DB00030 | INSR agonist; CPE modulator&product of | -- | Under clinical trials | Details |
| D316 | S-adenosyl-L-methionine | Chemical drug | DB00118 | GNMT cofactor | Antiviral | Under clinical trials | Details |
| D094 | Cysteamine | Chemical drug | DB00847 | GSS stimulant | Renal drug | Under clinical trials | Details |
| D095 | Cysteamine bitartrate | Chemical drug | DB00847 | -- | -- | Under clinical trials | Details |