Correlation of vitamin E, uric acid, and diet composition with histologic features of pediatric NAFLD.
Correlation of vitamin E, uric acid, and diet composition with histologic features of pediatric NAFLD.
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DOI：
10.1097/mpg.0b013e318229da1a
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发表时间：
2012-01
影响因子：
2.9
通讯作者：
NASH CRN Research Group
中科院分区：
文献类型：
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作者：
Vos MB;Colvin R;Belt P;Molleston JP;Murray KF;Rosenthal P;Schwimmer JB;Tonascia J;Unalp A;Lavine JE;NASH CRN Research Group
非酒精性脂肪肝病（NAFLD）是美国儿童中最常见的慢性肝病。尽管经常建议改变饮食来改善 NAFLD，但饮食对该疾病组织学特征的影响却知之甚少。这是一项基于前瞻性、横断面登记的研究。参加多中心 NASH 临床研究网络的儿童 (n=149) 获得了人口统计、人体测量、临床、实验室和组织学数据，包括简要食物调查问卷。根据 NASH-CRN 标准，根据是否存在脂肪性肝炎以及组织学特征的等级对受试者进行分组。与脂肪性肝炎儿童相比，脂肪变性儿童和脂肪性肝炎儿童之间来自脂肪、碳水化合物和蛋白质的热量比例没有显着差异。尽管尿酸（果糖摄入量的替代标志物）在患有明确 NASH 的患者中显着增加，但含糖饮料的消耗量较低，并且与组织学特征无关（p=.008）。对于所有组来说，维生素 E 的摄入量均低于建议的每日摄入量。脂肪变性程度较高的儿童维生素 E 的中位消耗量较低（I、II 和 III 级分别为 8.4 vs 6.1 vs 6.9，p = .05）。那些摄入较少维生素 C 的人气球样变性增加 (p = 0.05)。患有 NAFLD 的儿童饮食中维生素 E 不足，这可能会导致 NAFLD 的病理生理学。据报告，患有 NAFLD 的儿童的含糖饮料消费量较低；然而，尿酸可能反映了果糖的总消耗量，它与 NASH 显着相关，应进一步评估。
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children in the United States. Although changes in diet are often recommended to improve NAFLD, little is known regarding diet influence on histologic features of the disease. This was a prospective, cross-sectional registry based study. Children (n=149) enrolled in the multi-center NASH Clinical Research Network had demographic, anthropometric, clinical, laboratory and histology data obtained, including the Block Brief Food Questionnaire. Subjects were grouped by presence or absence of steatohepatitis and grades of histologic features according to NASH-CRN criteria. No significant differences were found between children with steatosis compared to steatohepatitis for fraction of calories from fat, carbohydrates, and protein. Sugar sweetened beverage consumption was low and did not correlate with histologic features, although uric acid, a surrogate marker for fructose intake, was significantly increased in those with definite NASH (p=.008). For all groups, vitamin E consumption was insufficient compared to the recommended daily allowance. Median consumption of vitamin E was lower in children with higher grade of steatosis (8.4 vs 6.1 vs 6.9 for grade I, II and III respectively, p = .05). Those consuming less vitamin C had increased ballooning degeneration (p = 0.05). Children with NAFLD have a diet that is insufficient in vitamin E and this may contribute to the pathophysiology of NAFLD. In children with NAFLD, reported sugar sweetened beverage consumption is low; however uric acid, which may reflect total fructose consumption, was significantly associated with NASH and should be further evaluated.