[논문]The Efficacy of Pharmacological Treatment in Pediatric Nonalcoholic Fatty Liver Disease

Cho, Taeshik; Kim, Yong Joo; Paik, Seung Sam

doi:10.5223/pghn.2012.15.4.256

[국내논문] The Efficacy of Pharmacological Treatment in Pediatric Nonalcoholic Fatty Liver Disease 원문보기

Pediatric gastroenterology, hepatology & nutrition, v.15 no.4, 2012년, pp.256 - 265

Cho, Taeshik (Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.) , Kim, Yong Joo (Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.) , Paik, Seung Sam (Department of Pathology, Hanyang University College of Medicine, Seoul, Korea.)

Abstract ▼ AI-Helper

PurposeWith growing number of obese children, the prevalence of nonalcoholic fatty liver disease (NAFLD) in pediatric population is increasing. Nonalcoholic steatohepatitis (NASH) is a severe form of NAFLD, and can cause morbid complications. It is important to identify patients in order to grade pathologic severities and treat those children who possibly have NASH. This study was performed to evaluate whether the pharmacological therapy is also effective as well as the body weight reduction in pediatric NAFLD.MethodsAmong the 52 children presenting with obesity and hepatopathy, NAFLD was diagnosed through liver biopsy in 29 children, who were 7 to 14 years of age, from January 2006 to December 2011. The patients were advised to reduce their body weight through diverse methods. Medication with Ursodeoxycholic acid (UDCA) and vitamin E was performed in children whose liver functions did not improve or their weight reductions were not successful. The therapeutic effects were monitored and assessed via the biochemical profiles and the physical measurements.ResultsThe therapy of vitamin E and UDCA combined with body mass index (BMI) reduction showed significantly higher rate of improvement in clinical profiles, which could be seen in data of aspartate aminotransferase (AST), alanine aminotransferase (ALT), AST/ALT ratio, alkaline phosphatase, total bilirubin and γ-glutamyl transpeptidase. Children whose BMI were successfully reduced showed favorable clinical improvements without any medication, but those without BMI reduction did not show any improvement despite medications.ConclusionThis study showed that the first line of therapy should be the BMI reduction in NAFLD and drug therapy combined with BMI reduction could have additive therapeutic effect in children with NAFLD.

주제어

참고문헌 (25)

1 Loomba R Sirlin CB Schwimmer JB Lavine JE Advances in pediatric nonalcoholic fatty liver disease Hepatology 2009 50 1282 1293 19637286
2 Park HS Han JH Choi KM Kim SM Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean adolescents Am J Clin Nutr 2005 82 1046 1051 16280437

상세보기
3 Tominaga K Kurata JH Chen YK Fujimoto E Miyagawa S Abe I Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey Dig Dis Sci 1995 40 2002 2009 7555456

상세보기
4 Widhalm K Ghods E Nonalcoholic fatty liver disease: a challenge for pediatricians Int J Obes (Lond) 2010 34 1451 1467 20838401

상세보기
5 Mencin AA Lavine JE Nonalcoholic fatty liver disease in children Curr Opin Clin Nutr Metab Care 2011 14 151 157 21178608
6 Dufour JF Oneta CM Gonvers JJ Bihl F Cerny A Cereda JM Swiss Association for the Study of the Liver. Randomized placebo-controlled trial of ursodeoxycholic acid with vitamin e in nonalcoholic steatohepatitis Clin Gastroenterol Hepatol 2006 4 1537 1543 17162245
7 Kleiner DE Brunt EM Van Natta M Behling C Contos MJ Cummings OW Nonalcoholic Steatohepatitis Clinical Research Network Design and validation of a histological scoring system for nonalcoholic fatty liver disease Hepatology 2005 41 1313 1321 15915461
8 Seo JW Nonalcoholic fatty liver disease in children Korean J Pediatr Gastroenterol Nutr 2011 14 209 221
9 Manco M Marcellini M Devito R Comparcola D Sartorelli MR Nobili V Metabolic syndrome and liver histology in paediatric non-alcoholic steatohepatitis Int J Obes (Lond) 2008 32 381 387 18087267

상세보기
10 Nobili V Alkhouri N Alisi A Ottino S Lopez R Manco M Retinol-binding protein 4: a promising circulating marker of liver damage in pediatric nonalcoholic fatty liver disease Clin Gastroenterol Hepatol 2009 7 575 579 19268270
11 Alkhouri N Carter-Kent C Lopez R Rosenberg WM Pinzani M Bedogni G A combination of the pediatric NAFLD fibrosis index and enhanced liver fibrosis test identifies children with fibrosis Clin Gastroenterol Hepatol 2011 9 150 155 20888433
12 Nobili V Alkhouri N Bartuli A Manco M Lopez R Alisi A Severity of liver injury and atherogenic lipid profile in children with nonalcoholic fatty liver disease Pediatr Res 2010 67 665 670 20496475
13 Jee SJ Kim YJ Song SY Paik SS Association among histopathology, clinical manifestation, and ultrasonographic grades in pediatric non-alcoholic fatty liver disease Korean J Gastroenterol 2011 57 158 165 21519163
14 Nobili V Marcellini M Devito R Ciampalini P Piemonte F Comparcola D NAFLD in children: a prospective clinical-pathological study and effect of lifestyle advice Hepatology 2006 44 458 465 16871574
15 Chalasani N Younossi Z Lavine JE Diehl AM Brunt EM Cusi K The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association Hepatology 2012 55 2005 2023 22488764
16 Houmard JA Tanner CJ Slentz CA Duscha BD McCartney JS Kraus WE Effect of the volume and intensity of exercise training on insulin sensitivity J Appl Physiol 2004 96 101 106 12972442

상세보기
17 Paumgartner G Beuers U Mechanisms of action and therapeutic efficacy of ursodeoxycholic acid in cholestatic liver disease Clin Liver Dis 2004 8 67 81 15062194

상세보기
18 Laurin J Lindor KD Crippin JS Gossard A Gores GJ Ludwig J Ursodeoxycholic acid or clofibrate in the treatment of non-alcohol-induced steatohepatitis: a pilot study Hepatology 1996 23 1464 1467 8675165
19 Lindor KD Kowdley KV Heathcote EJ Harrison ME Jorgensen R Angulo P Ursodeoxycholic acid for treatment of nonalcoholic steatohepatitis: results of a randomized trial Hepatology 2004 39 770 778 14999696
20 Leuschner UF Lindenthal B Herrmann G Arnold JC Rössle M Cordes HJ NASH Study Group High-dose ursodeoxycholic acid therapy for nonalcoholic steatohepatitis: a double-blind, randomized, placebo-controlled trial Hepatology 2010 52 472 479 20683947
21 Ratziu V de Ledinghen V Oberti F Mathurin P Wartelle-Bladou C Renou C FRESGUN A randomized controlled trial of high-dose ursodesoxycholic acid for nonalcoholic steatohepatitis J Hepatol 2011 54 1011 1019 21145828

상세보기
22 Strauss RS National Health and Nutrition Examination Survey Comparison of serum concentrations of alpha-tocopherol and beta-carotene in a cross-sectional sample of obese and nonobese children (NHANES III) J Pediatr 1999 134 160 165 9931523
23 Hasegawa T Yoneda M Nakamura K Makino I Terano A Plasma transforming growth factor-beta1 level and efficacy of alpha-tocopherol in patients with non-alcoholic steatohepatitis: a pilot study Aliment Pharmacol Ther 2001 15 1667 1672 11564008

상세보기
24 Harrison SA Torgerson S Hayashi P Ward J Schenker S Vitamin E and vitamin C treatment improves fibrosis in patients with nonalcoholic steatohepatitis Am J Gastroenterol 2003 98 2485 2490 14638353

상세보기
25 Lavine JE Schwimmer JB Van Natta ML Molleston JP Murray KF Rosenthal P Nonalcoholic Steatohepatitis Clinical Research Network Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents: the TONIC randomized controlled trial JAMA 2011 305 1659 1668 21521847

상세보기

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

[국내논문] The Efficacy of Pharmacological Treatment in Pediatric Nonalcoholic Fatty Liver Disease 원문보기

Abstract ▼ AI-Helper

주제어

참고문헌 (25)

이 논문을 인용한 문헌

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트