Research Article Details
| Article ID: | A27098 |
| PMID: | 19183714 |
| Source: | Paediatr Child Health |
| Title: | Anthropometric and metabolic characteristics in children with clinically diagnosed nonalcoholic fatty liver disease. |
| Abstract: | BACKGROUND: Childhood obesity is currently approaching epidemic proportions worldwide. Various chronic diseases are associated with obesity, but nonalcoholic fatty liver disease (NAFLD) has received little attention from paediatricians. AIM: To examine anthropometric and metabolic variables relevant to NAFLD disease mechanism and severity. METHODS: A retrospective review of 53 consecutive paediatric patients clinically diagnosed with NAFLD was performed between 1997 and 2004. Variables studied included ethnicity, body mass index, acanthosis nigricans, aspartate aminotransferase and alanine amino-transferase levels, and fasting levels of glucose, insulin and lipids. Insulin resistance was quantified by validated models (the homeostasis model of insulin resistance [HOMA-IR] and the quantitative insulin-sensitivity check index [QUICKI]). RESULTS: The cohort was comprised of 34 boys and 19 girls; there was a 2:1 male predominance. The mean age of the children was 13.5 years (median 14.2 years; range 5.6 to 18.9 years), and 13 were 11 years of age or younger. Forty-five per cent were Caucasian, 30% Asian and 21% Hispanic. Thirty-eight children (72%) were classified as obese and 11 children (21%) were classified as overweight, with a mean ideal body weight percentage of 150.9+/-4.2 (range 67% to 226%) and a BMI Z score of 1.9+/-0.1 (range -1.2 to 3.2). Hyperinsulinemia was present in 35 children (66%). Insulin resistance (HOMA-IR 9.8+/-2.6, abnormal if greater than 3) was associated with increased plasma triglyceride (P=0.03) and total cholesterol (P=0.04) levels. These parameters were significant irrespective of alanine aminotransferase or aspartate aminotransferase levels. CONCLUSIONS: Hyperlipidemia with hyperinsulinemia and insulin resistance in overweight and obese children with fatty liver may be important signs of liver dysfunction in childhood NAFLD, irrespective of serum aminotransferases. In overweight or obese children with hyperlipidemia or insulin resistance, evaluation for NAFLD is warranted. |
| DOI: |
| 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 |
| D328 | Serine | Chemical drug | DB00133 | SRR | Improve insulin resistance | Under clinical trials | Details |
| D080 | Citrulline | Chemical drug | DB00155 | -- | -- | Under clinical trials | Details |
| D083 | CLA | Chemical drug | DB01211 | KCNH2; SLCO1B1; SLCO1B3 | -- | Under clinical trials | Details |
| D182 | Insulin | Biological drug | DB00030 | INSR agonist; CPE modulator&product of | -- | 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 |