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Investigation of Clinical and Pathological Relationships between Adult-and Pediatric-type NASH in Korean Children

Title
Investigation of Clinical and Pathological Relationships between Adult-and Pediatric-type NASH in Korean Children
Author
김용주
Keywords
Non-alcoholic Steatohepatitis; Children; Liver; Pathology
Issue Date
2018-01
Publisher
KOREAN ACAD MEDICAL SCIENCES
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v. 33, no. 5, Article no. UNSP e34
Abstract
Background: Histologically, nonalcoholic steatohepatitis (NASH) is categorized into adult-type (type 1) and pediatric-type (type 2). The origination of the histological difference between the two types and how they differ clinically remain uncertain. We aimed to understand the incidence and clinical characteristics of the two types of NASH in Korean children, and to investigate the association between their pathological type and clinical characteristics, using anthropometric and laboratory data.Methods: In 38 children with confirmed NASH, we investigated hepatic pathological findings, and correlating factors between pathological type and laboratory and anthropometric data (weight percentile, body mass index (BMI) z-score, and blood pressure percentile). Adult-type NASH was noted in 21 patients and pediatric-type in 17 patients.Results: Age, sex, BMI, transaminase levels, and insulin resistance were not significantly different between the two groups. Triglyceride (TG) levels were higher in adult-type NASH (P = 0.033). Hematocrit and albumin levels were lower in adult-type NASH (P = 0.016 and 0.013, respectively). Hepatic fibrosis was more common in pediatric-type. The fibrosis scores in patients with adult-type were mostly 0 and 1, whereas the score was 3 in patients with pediatric-type (P = 0.024, 0.004, and < 0.010, respectively). Anthropometric data, liver function, and insulin resistance scores did not differ between the two pathological NASH types. TG, hematocrit, and albumin may be potential factors to predict pathological types. Fibrosis was observed more frequently in pediatric-type NASH.Conclusion: Monitoring children with pediatric-type NASH for progression to fibrosis or cirrhosis is recommended.
URI
https://jkms.org/DOIx.php?id=10.3346/jkms.2018.33.e34http://repository.hanyang.ac.kr/handle/20.500.11754/116912
ISSN
1011-8934; 1598-6357
DOI
10.3346/jkms.2018.33.e34
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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