Clinical and Histological Features of Nonalcoholic Fatty Liver Disease in Children
Clinical and Histological Features of Nonalcoholic Fatty Liver Disease in Children
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DOI：
10.1007/s10620-009-0949-3
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发表时间：
2009-10-01
影响因子：
3.1
通讯作者：
Seo, Jeong Kee
中科院分区：
文献类型：
--
作者：
Ko, Jae Sung;Yoon, Jung Min;Seo, Jeong Kee
非酒精性脂肪性肝病（NAFLD）是一种常见的非酒精性肝病，随着儿童肥胖率的迅速增加，NAFLD的诊断率也越来越高。本研究旨在探讨NAFLD患儿的临床表现与组织病理学特征之间的相关性。我们回顾了首尔国立大学医院经活检证实的NAFLD患儿的临床资料和肝脏组织学结果。NAFLD分为单纯性脂肪变性、1型非酒精性脂肪性肝炎（NASH）（以气球样变性和窦周纤维化为特征）或2型NASH（以门静脉炎症和门静脉纤维化为特征）。在总共80名患者中，84%为男性。所有患者均肥胖或超重。96%的儿童存在胰岛素抵抗。45%的儿童出现窦周纤维化，77%的儿童出现门静脉纤维化。22%的儿童存在单纯性脂肪变性，34%为1型NASH，44%为2型NASH。NAFLD亚型或NAFLD活动评分在性别、血压或转氨酶水平、空腹血脂或胰岛素方面无差异。NASH儿童年龄较大，体重指数高于单纯脂肪变性儿童。与1型NASH患者相比，2型NASH患者的体重指数更高，纤维化更严重。肥胖和年龄较大与NASH的发生有关。2型NASH是最常见的形式，并且与更严重的肥胖和晚期纤维化相关。
Nonalcoholic fatty liver disease (NAFLD) is becoming more frequently diagnosed as the prevalence of obesity in children increases rapidly.The aim of this study was to investigate the correlation of clinical findings with histopathologic features in children with NAFLD.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.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.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.