Pediatr Gastroenterol Hepatol Nutr.  2012 Dec;15(4):256-265.

The Efficacy of Pharmacological Treatment in Pediatric Nonalcoholic Fatty Liver Disease

• Cho T
• Kim YJ
• Paik SS

Abstract

PURPOSE
With 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.
METHODS
Among 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.
RESULTS
The 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 gamma-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.
CONCLUSION
This 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.

Keyword

Child; Nonalcoholic fatty liver disease; Vitamin E; Ursodeoxycholic acid; Pharmacotherapy

MeSH Terms

Alanine Transaminase
Alkaline Phosphatase
Aspartate Aminotransferases
Bilirubin
Biopsy
Body Mass Index
Body Weight
Child
Fatty Liver
gamma-Glutamyltransferase
Humans
Liver
Obesity
Prevalence
Ursodeoxycholic Acid
Vitamin E
Vitamins
Weight Loss
Alanine Transaminase
Alkaline Phosphatase
Aspartate Aminotransferases
Bilirubin
Fatty Liver
Ursodeoxycholic Acid
Vitamin E
Vitamins
gamma-Glutamyltransferase

Figure

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  Fig. 1 Age and sex distributions of the children at the time of diagnosis.

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