Clinical and histological features of nonalcoholic fatty liver disease in children.
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is becoming more frequently diagnosed as the prevalence of obesity in children increases rapidly.


OBJECTIVE
The aim of this study was to investigate the correlation of clinical findings with histopathologic features in children with NAFLD.


METHODS
We reviewed the clinical data and liver histology results of children with biopsy-proven NAFLD at Seoul National University Hospital. NAFLD was classified as simple steatosis, type 1 nonalcoholic steatohepatitis (NASH), characterized by ballooning degeneration and perisinusoidal fibrosis, or type 2 NASH, characterized by portal inflammation and portal fibrosis.


RESULTS
Among 80 total patients, 84% were male. All patients were obese or overweight. Insulin resistance was present in 96% of children. Perisinusoidal fibrosis was noted in 45% of children and portal fibrosis was noted in 77%. Simple steatosis was present in 22% of children, type 1 NASH in 34%, and type 2 NASH in 44%. No differences were found among NAFLD subtypes or NAFLD activity score with regard to sex, blood pressure, or levels of aminotransferase, fasting lipid, or insulin. Children with NASH were older and had higher body mass index than those with simple steatosis. Patients with type 2 NASH had higher body mass index and advanced fibrosis compared with patients with type 1 NASH.


CONCLUSIONS
Obesity and older age are associated with development of NASH. Type 2 NASH is the most common form and associated with a greater severity of obesity and advanced fibrosis.
Ko
Jae Sung
JS
Department of Pediatrics, Seoul National University College of Medicine, Jongrogu, Seoul 110-744, Korea. kojs@snu.ac.kr
Yoon
Jung Min
JM
Yang
Hye Ran
HR
Myung
Jae Kyung
JK
Kim
Haeryoung
H
Kim
Hye Ryeung
HR
Kang
Gyeong Hoon
GH
Cheon
Jung-Eun
JE
Seo
Jeong Kee
JK
D000367:Age Factors; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D005234:Fatty Liver / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D009765:Obesity / Q000150:complications; D000637:Transaminases / Q000097:blood
D007328:Insulin; D008055:Lipids; D000637:Transaminases
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