Pediatr Gastroenterol Hepatol Nutr.  2015 Sep;18(3):168-174. 10.5223/pghn.2015.18.3.168.

Low Serum Potassium Levels Associated with Disease Severity in Children with Nonalcoholic Fatty Liver Disease

• Tabbaa A
• Shaker M
• Lopez R
• Hoshemand
• Nobili V
• Alkhouri N

• KMID: 2068793
• DOI: http://doi.org/10.5223/pghn.2015.18.3.168

Abstract

PURPOSE
Recent studies have suggested that decreased serum potassium level may contribute to various metabolic disorders in adult patients including nonalcoholic fatty liver disease (NAFLD). We aimed to study the correlation between serum potassium levels and the histologic severity of NAFLD in children.
METHODS
Pediatric patients with biopsy-proven NAFLD were included in this study. Demographic, clinical, and histopathological data were obtained. Multivariable logistic regression analysis was used to assess whether potassium levels are associated with the presence of nonalcoholic steatohepatitis (NASH) or fibrosis after adjusting for possible confounders. A p-value <0.05 was considered statistically significant.
RESULTS
Among 125 biopsies, 49.6% (62) had evidence of NASH while 66.4% (83) had some degree of fibrosis (stage 1-3). Mean serum potassium was significantly lower in NASH group as compared to non-NASH group (4.4+/-0.42 mmoL/L vs. 4.8+/-0.21, p<0.001). Higher potassium level had negative correlation with presence of steatosis, ballooning, lobular inflammation, fibrosis and NAFLD activity score (p<0.05). On multivariable analysis and after adjusting for the metabolic syndrome and insulin resistance, higher potassium level was significantly associated with lower likelihood of having a histological diagnosis of NASH on biopsy (odds ratio [OR], 0.12; 95% confidence interval [95% CI], 0.05-0.28; p<0.001). Similarly, the likelihood of having fibrosis decreases by 76% for every 0.5 mmoL/L increase in potassium (OR ,0.24; 95% CI, 0.11-0.54; p<0.001).
CONCLUSION
Our study shows an inverse relationship between serum potassium levels and the presence of aggressive disease (NASH and fibrosis) in children with NAFLD.

Keyword

Pediatrics; Fibrosis; Anatomy & histology; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Potassium

MeSH Terms

Adult
Biopsy
Child*
Diagnosis
Fatty Liver*
Fibrosis
Humans
Inflammation
Insulin Resistance
Logistic Models
Pediatrics
Potassium*
Potassium

Figure

• 

  Fig. 1 Potassium levels in patients with and without nonalcoholic steatohepatitis (NASH). The box represents the interquartile range (25th and 75th percentiles) from the median (the horizontal line). The bars represent the 95% confidence interval. The median potassium level was significantly lower than in the NASH group compared with the non-NASH group (4.4±0.42 mmoL/L vs. 4.8±0.21, p<0.001).

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