Efficacy of Weight Reduction on Pediatric Nonalcoholic Fatty Liver Disease: Opportunities to Improve Treatment Outcomes Through Pharmacotherapy.
Efficacy of Weight Reduction on Pediatric Nonalcoholic Fatty Liver Disease: Opportunities to Improve Treatment Outcomes Through Pharmacotherapy.
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DOI：
10.3389/fendo.2021.663351
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发表时间：
2021
影响因子：
5.2
通讯作者：
Shakhnovich V
中科院分区：
文献类型：
--
作者：
Friesen CS;Hosey-Cojocari C;Chan SS;Csanaky IL;Wagner JB;Sweeney BR;Friesen A;Fraser JD;Shakhnovich V
肥胖是非酒精性脂肪肝（NAFLD）的最大风险因素。在没有干预的情况下，大多数NAFLD儿科患者继续体重过度增加，这使得早期有效的减肥干预成为疾病治疗和预防NAFLD进展的关键。不幸的是，在一个不能代表真实的世界的密切监测的研究环境之外，改变生活方式对儿童减肥的成功率很低。减肥手术虽然有效，但具有侵入性，术后会使NAFLD恶化。因此，药物治疗在儿童中的作用不断发展，但未得到充分利用，无论是在减肥还是在NAFLD管理方面。在这篇前瞻性文章中，我们概述了减肥对儿童NAFLD治疗的疗效，讨论了目前批准的药物治疗方案的利弊，以及儿童和青少年减肥的常用药物。我们还强调了精简肥胖试验的差距和机会，将NAFLD评估作为一种有价值的次要治疗结果指标，这可能有助于药物再利用。最后，我们描述了已经可用的和新兴的NAFLD微创生物标志物，这些生物标志物可以在儿童肥胖和NAFLD试验中提供安全方便的肝活检替代品。
Obesity is the single greatest risk factor for nonalcoholic fatty liver disease (NAFLD). Without intervention, most pediatric patients with NAFLD continue to gain excessive weight, making early, effective weight loss intervention key for disease treatment and prevention of NAFLD progression. Unfortunately, outside of a closely monitored research setting, which is not representative of the real world, lifestyle modification success for weight loss in children is low. Bariatric surgery, though effective, is invasive and can worsen NAFLD postoperatively. Thus, there is an evolving and underutilized role for pharmacotherapy in children, both for weight reduction and NAFLD management. In this perspective article, we provide an overview of the efficacy of weight reduction on pediatric NAFLD treatment, discuss the pros and cons of currently approved pharmacotherapy options, as well as drugs commonly used off-label for weight reduction in children and adolescents. We also highlight gaps in, and opportunities for, streamlining obesity trials to include NAFLD assessment as a valuable, secondary, therapeutic outcome measure, which may aid drug repurposing. Finally, we describe the already available, and emerging, minimally-invasive biomarkers of NAFLD that could offer a safe and convenient alternative to liver biopsy in pediatric obesity and NAFLD trials.
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DOI：
10.1002/oby.21782
发表时间：
2017-04
期刊：
Obesity (Silver Spring, Md.)
影响因子：
--
作者：
Freedman DS;Butte NF;Taveras EM;Lundeen EA;Blanck HM;Goodman AB;Ogden CL
通讯作者：
Ogden CL
影响因子：
5.1
作者：
Alkhouri, Naim;Kohli, Rohit;Feldstein, Ariel E.
通讯作者：
Feldstein, Ariel E.
影响因子：
8
作者：
Freedman, David S.;Berenson, Gerald S.
通讯作者：
Berenson, Gerald S.
影响因子：
168.9
作者：
Athyros, Vasilios G.;Tziomalos, Konstantinos;Mikhailidis, Dimitri P.
通讯作者：
Mikhailidis, Dimitri P.
影响因子：
5.1
作者：
Danne, Thomas;Biester, Torben;Kordonouri, Olga
通讯作者：
Kordonouri, Olga