Pediatric Nonalcoholic Fatty Liver Disease: the Rise of a Lethal Disease Among Mexican American Hispanic Children.
Hispanic children of Mexican origin have a high incidence of NAFLD. Susceptibility has been linked to a combination of factors including an increasing epidemic of obesity in children and adolescents, an allele substitution in the PNPLA3 gene that reduces hepatic lipid catabolism, and an altered microbiome that may increase hepatic endotoxins. The combination of NAFLD and portal vein toxins secondary to an indigenous gut microbiome appear to lead to the early occurrence of NASH, which progresses to cirrhosis and early hepatocellular carcinoma. Early detection and treatment of hepatic changes are needed. Given the success of gastric bypass in reducing body weight, modifying the gut microbiome, and improving NAFLD/NASH in adults, a trial of gastric bypass in predisposed pediatric candidates should be undertaken.
Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA. m.betancourt@dhr-rgv.com.
Monica M
MM
Betancourt-Garcia
Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA.
Armando
A
Arguelles
Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA.
Jorge
J
Montes
Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA.
Ambrosio
A
Hernandez
Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA.
Manish
M
Singh
Doctors Hospital at Renaissance Health Care System, 5501 S McColl Rd., Edinburg, TX, 78539, USA.
R Armour
RA
Forse
D000293:Adolescent; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D002648:Child; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008113:Liver Neoplasms / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008800:Mexico / Q000208:ethnology; D064307:Microbiota / Q000502:physiology; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000208:ethnology* / Q000401:mortality*; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology / Q000208:ethnology / Q000601:surgery; D063766:Pediatric Obesity / Q000150:complications / Q000208:ethnology / Q000401:mortality
Epidemiology; Gut microbiome; Hepatic steatosis; Mexican American; PNPLA3; Pediatric nonalcoholic fatty liver disease