Articles | Open Access | https://doi.org/10.37547/ajbspi/Volume04Issue03-04

STEATOHEPATITIS IN OBESITY CHILDREN

Garifulina Lilya Maratovna , Candidate of Medical Sciences, Associate Professor of the Department of Pediatrics, Faculty of Medicine SamSMU, Uzbekistan
Turaeva Dilafruz Kholmurodovna , Assistant of the Department of Pediatrics, Faculty of Medicine SamSMU, Uzbekistan
Norkulova Aziza Rustamovna , RCEMPNC SF pediatrician, 2nd children's department, Uzbekistan

Abstract

Steatohepatitis is hepatic steatosis with inflammation and, in some cases, hepatocyte balloon degeneration and fibrosis [1]. Steatohepatitis is a form of non-alcoholic fatty liver disease (NAFLD), which includes a wide range of conditions: from non-alcoholic steatosis (NAS) - fat deposition in the liver of more than 5% of the parenchymal mass without signs of damage to hepatocytes to non-alcoholic steatohepatitis (NASH), which progresses with development fibrosis, cirrhosis and, in some patients, hepatocellular carcinoma [1]. The prevalence of steatohepatitis in the pediatric population, according to various sources, varies greatly. Thus, the recommendations of the North American Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists (NASPGHAN) indicate that hypertransaminasemia occurs in 29-38% of obese children aged 2-4 years [1]. According to A. Sahota et al. [2], NASH was found in 12% of obese and overweight children. The joint recommendations for the diagnosis, treatment and prevention of obesity in children and adolescents of the Russian Association of Endocrinologists, the Russian Society for the Prevention of Non-Infectious Diseases, and the Association of Pediatric Cardiologists of Russia note that NASH is diagnosed in 12-26% of obese children and adolescents [3]. Obesity and overweight currently affect 25-30% of school-age children [4]. The situation is almost the same for preschool children. The COSI (Childhood Obesity Surveillance Initiative) study, conducted under the WHO program in Moscow in 2017-2018, summing up the dynamics of body weight for the entire preschool period, showed that among children aged 7 years, 27% of boys were overweight and 22% of girls, and obesity - in 10 and 6%, respectively [5].  Another Russian study assessing the physical development of children of middle and school age [6] also demonstrated a significant prevalence of obesity and overweight in this age group in Russian regions. Thus, at 11 years of age, obesity in boys was recorded in 18.6% of cases, in girls - in 9.2%, and excess body weight - in 15.4 and 14.3%, respectively. At the age of 15, obesity was detected in 10% of cases among boys, in 3.6% of girls, and overweight in 11.5 and 10.5% of cases, respectively [6]. Based on these data, it can be assumed that the incidence of NASH in the pediatric population varies from 0.5 to 3%. It should be noted that the prevalence of obesity, and with it NAFLD, including NASH, is increasing throughout the world due to modern negative trends in the diet and physical activity of children [7].

Keywords

Population, hepatocytes, non-alcoholic steatosis (NAS)

References

Vos MB, Abrams SH, Barlow SE, et al. NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children: Recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr. 2017;64(2):319-334. doi: 10.1097/ MPG.0000000000001482

Sahota AK, Shapiro WL, Newton KP, et al. Incidence of Nonalcoholic Fatty Liver Disease in Children: 2009-2018. Pediatrics. 2020;146(6):e20200771. doi: 10.1542/peds.2020-0771

Vajro P, Lenta S, Socha P, et al. Diagnosis of nonalcoholic fatty liver disease in children and adolescents: position paper of the ESPGHAN Hepatology Committee. J Pediatr Gastroenterol Nutr. 2012;54(5):700-713. doi: 10.1097/MPG.0b013e318252a13f

Rito AI, Buoncristiano M, Spinelli A, et al. Association between Characteristics at Birth, Breastfeeding and Obesity in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative — COSI 2015/2017. Obes Facts. 2019;12(2):226-243. doi: 10.1159/000500425

Mapping the health system response to childhood obesity in the WHO European Region. An overview and country perspectives. Copenhagen: World Health Organization Regional Office for Europe; 2019. 4 p. Available online: https://www.euro.who.int/__data/ assets/pdf_file/0019/401176/Childhood-obesity-web.pdf. Accessed on June 23, 2021.

Neuschwander-Tetri BA. Non-alcoholic fatty liver disease. BMC Med. 2017;15(1):45. doi: 10.1186/s12916-017-0806-8

Ling JR, Zhang YJ, Zhang ZH, et. al. Specific changes of intestinal microflora in children with nonalcoholic fatty liver disease. Zhonghua Er Ke Za Zhi. 2018;56(11):850-855. doi: 10.3760/ cma.j.issn.0578-1310.2018.11.011

Yang F, Dai Y, Min C, Li X. Neonatal overfeeding induced glucocorticoid overexposure accelerates hepatic lipogenesis in male rats. Nutr Metab (Lond). 2018;15:30 doi: 10.1186/ s12986-018-0272-0

Flisiak-Jackiewicz M, Lebensztejn DM. Update on pathogenesis, diagnostics and therapy of nonalcoholic fatty liver disease in children. Clin Exp Hepatol. 2019;5(1):11-21. doi: 10.5114/ ceh.2019.83152

Богомолов П.О., Кокина К.Ю., Майоров А.Ю., Мишина Е.Е. Генетические аспекты неалкогольной жировой болезни печени // Вопросы современной педиатрии. — 2018. — Т. 17. — № 6. — С. 442-448. [Bogomolov PO, Kokina KYu, Mayorov AYu, Mishina EE. Genetic Aspects of Non-Alcoholic Fatty Liver Disease. Voprosy sovremennoi pediatrii — Current Pediatrics. 2018;17(6):442-448. (In Russ).] doi: 10.15690/vsp.v17i6.1974

Nikolaou N, Gathercole L, Marchand L, et al. AKR1D1 is a novel regulator of metabolic phenotype in human hepatocytes and is dysregulated in non-alcoholic fatty liver disease. Metabolism. 2019;99:67-80. doi: 10.1016/j.metabol.2019.153947

Wang X, Zhou Y, Zhang M, et al. The methylenetetrahydrofolate reductase genotype 677CT and non-alcoholic fatty liver disease have a synergistic effect on the increasing homocysteine levels in subjects from Chongqing, China. Genes Dis. 2018;6(1):88-95. doi: 10.1016/j.gendis.2018.07.003

Kong M, Longdong Zhu, Bai L, et al. Vitamin D deficiency promotes nonalcoholic steatohepatitis through impaired enterohepatic circulation in animal model. Am J Physiol Gastrointest Liver Physiol. 2014;307(9):G883-G893. doi: 10.1152/ajpgi.00427.2013

Cimini FA, Barchetta I, Carotti S, et al. Relationship between adipose tissue dysfunction, vitamin D deficiency and the pathogenesis of non-alcoholic fatty liver disease. World J Gastroenterol. 2017;23(19):3407-3417. doi: 10.3748/wjg.v23.i19.3407

Yodoshi, T, Orkin S, Arce-Clachar AC, et al. Vitamin D deficiency: prevalence and association with liver disease severity in pediatric nonalcoholic fatty liver disease. Eur J Clin Nutr. 2020;74(3): 427-435. doi: 10.1038/s41430-019-0493-y

Schwimmer JB, Newton KP, Awai HI, et al. Paediatric gastroenterology evaluation of overweight and obese children referred from primary care for suspected non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2013;38(10):1267-1277. doi: 10.1111/apt.12518

Chen J, Chen J, Fu H, et al. Hypoxia exacerbates non-alcoholic fatty liver disease via HIF-2a/PPARa pathway. Am J Physiol Endocrinol Metab. 2019;317(4):E710-E722. doi: 10.1152/ ajpendo.00052.2019

Elkabany ZA, Hamza RT, Ismail EAR, et al. Serum visfatin level as a noninvasive marker for nonalcoholic fatty liver disease in children and adolescents with obesity: relation to transient elastography with controlled attenuation parameter. Eur J Gastroenterol Hepatol. 2020;32(8):1008-1016. doi: 10.1097/MEG.0000000000001608

Wen H, Wang HJ, Dong B, Ma J. Relationship between serum visfatin level and children and adolescent obesity and nonalcoholic fatty liver disease. Zhonghua Liu Xing Bing Xue Za Zhi. 2012;33(3):269-272.

Kudratova G.N., Kholmuradova Z.E. “Changes in the secretory-enzymatic function of the gastric in infant children depending on the severity of anemia”.Journal of hepato-gastroenterology research. Special Issue. pp.47-50

Cura-Esquivel I, Cordero-Perez P Torres-Gonzalez L, Munoz-Espinosa LE. Acute phase markers in obese children and adolescents with metabolic disorders. Arch Argent Pediatr. 2018;116(4): 275-282. doi: 10.5546/aap.2018.eng.275

Hua M, Huang J-L, Hu C-C, et al. Including Fibroblast Growth Factor-21 in Combined Biomarker Panels Improves Predictions of Liver Steatosis Severity in Children. Front Pediatr. 2019;7:420. doi: 10.3389/fped.2019.00420

Aksoy GK, Artan R, Aksoy C, et al. Role of Soluble Adiponectin Receptor 2 in Non-Alcoholic Fatty Liver Disease in Children. Pediatr Gastroenterol Hepatol Nutr. 2019;22(5):470-478. doi: 10.5223/ pghn.2019.22.5.470

N., Kudratova G., et al. "Secretary Function of the Stomach in Young Children, Patients with Iron Deficiency Anemia, Depending on the Treatment Methods." International Journal of Innovations in Engineering Research and Technology, vol. 8, no. 3, 2021, pp. 28-31.

Mann JP, Raponi M, Nobili V. Clinical implications of understanding the association between oxidative stress and pediatric NAFLD. Expert Rev Gastroenterol Hepatol. 2017;11(4):371-382. doi: 10.1080/17474124.2017.1291340

Tilg H, Hotamisligil GS. Nonalcoholic fatty liver disease: cytokine-adipokine interplay and regulation of insulin resistance. Gastroenterology. 2006;131(3):934-945. doi: 10.1053/j.gastro.2006.05.054

Ballestri S, Lonardo A, Romagnoli D, et al. Ultrasonographic fatty liver indicator, a novel score which rules out NASH and is correlated with metabolic parameters in NAFLD. Liver Int. 2012;32(8): 1242-1252. doi: 10.1111/j.1478-3231.2012.02804.x

Кудратова, Г., & Холмуродова , З. (2022). ОПРЕДЕЛЕНИЕ КОЛИЧЕСТВА МОЧИ В ЖЕЛУДОЧНОМ СОКУ У БОЛЬНЫХ АНЕМИЯМИ И ЕГО ЗНАЧЕНИЕ. Журнал гепато-гастроэнтерологических исследований, 2(3.1), 36–41.

Liu H, Yang MC, Su YT, et al. Novel Ultrasonographic Fatty Liver Indicator Can Predict Hepatitis in Children With Non-alcoholic Fatty Liver Disease. Front Pediatr. 2019;6:416. doi: 10.3389/ fped.2018.00416

Kwon YD, Ko KO, Lim JW, et al. Usefulness of Transient Elastography for Non-Invasive Diagnosis of Liver Fibrosis in Pediatric Non-Alcoholic Steatohepatitis. J Korean Med Sci. 2019;34(23):e165. doi: 10.3346/jkms.2019.34.e165

Bedossa P. Current histological classification of NAFLD: strength and limitations. Hepatol Int. 2013;7(2):765-770. doi: 10.1007/ s12072-013-9446-z

Poynard T, Lassailly G, Diaz E, et al. Performance of biomarkers FibroTest, ActiTest, SteatoTest, and NashTest in patients with severe obesity: meta analysis of inpidual patient data. PLoS One. 2012;7(3):e30325. doi: 10.1371/journal.pone.0030325

Lin HZ, Yang SQ, Chuckaree C, et al. Metformin reverses fatty liver disease in obese, leptin-deficient mice. Nat Med. 2000;6(9): 998-1003. doi: 10.1038/79697

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Garifulina Lilya Maratovna, Turaeva Dilafruz Kholmurodovna, & Norkulova Aziza Rustamovna. (2024). STEATOHEPATITIS IN OBESITY CHILDREN. American Journal Of Biomedical Science & Pharmaceutical Innovation, 4(03), 24–35. https://doi.org/10.37547/ajbspi/Volume04Issue03-04