J Korean Med Sci.  2018 Jan;33(5):e34. 10.3346/jkms.2018.33.e34.

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

Affiliations
  • 1Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea. kyjoo@hanyang.ac.kr
  • 2Department of Pathology, Konyang University College of Medicine, Daejeon, Korea.

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.

Keyword

Non-alcoholic Steatohepatitis; Children; Liver; Pathology

MeSH Terms

Blood Pressure
Body Mass Index
Child*
Fibrosis
Hematocrit
Humans
Incidence
Insulin Resistance
Liver
Non-alcoholic Fatty Liver Disease
Pathology
Triglycerides
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error