Correlation of Vitamin E, uric acid and diet composition with histologic features of pediatric nonalcoholic fatty liver disease

the NASH CRN Research Group

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Objectives - 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. Methods - 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. Results - 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). Conclusions - 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.

Original languageEnglish (US)
Pages (from-to)90-96
Number of pages7
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume54
Issue number1
DOIs
StatePublished - Jan 1 2012

Fingerprint

Uric Acid
Vitamin E
Pediatrics
Diet
Beverages
Fatty Liver
Fructose
Recommended Dietary Allowances
Ascorbic Acid
Registries
Non-alcoholic Fatty Liver Disease
Liver Diseases
Histology
Chronic Disease
Biomarkers
Fats
Carbohydrates
Demography
Food
Research

Keywords

  • nonalcoholic steatohepatitis
  • nutrition
  • sugar-sweetened beverages
  • vitamin C

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

Cite this

Correlation of Vitamin E, uric acid and diet composition with histologic features of pediatric nonalcoholic fatty liver disease. / the NASH CRN Research Group.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 54, No. 1, 01.01.2012, p. 90-96.

Research output: Contribution to journalArticle

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title = "Correlation of Vitamin E, uric acid and diet composition with histologic features of pediatric nonalcoholic fatty liver disease",
abstract = "Objectives - 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. Methods - 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. Results - 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). Conclusions - 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.",
keywords = "nonalcoholic steatohepatitis, nutrition, sugar-sweetened beverages, vitamin C",
author = "{the NASH CRN Research Group} and Vos, {Miriam B.} and Ryan Colvin and Patricia Belt and Molleston, {Jean P.} and Murray, {Karen F.} and Philip Rosenthal and Jeffrey Schwimmer and James Tonascia and Aynur Unalp and Lavine, {Joel E.} and Stephanie Abrams and Diana Arceo and Denise Espinosa and Fairly, {Leanel Angeli} and Carol Hawkins and Liu, {Yao Chang} and Margaret Stager and Arthur McCullough and Srinivasan Dasarathy and Ruth Sargent and Melissa Coffey and Melissa Young and Parvathi Mohan and Kavita Nair and Manal Abdelmalek and Diehl, {Anna Mae} and Marcia Gottfried and Cynthia Guy and Paul Killenberg and Samantha Kwan and Pan, {Yi Ping} and Dawn Piercy and Melissa Smith and Prajakta Bhimalli and Naga Chalasani and Cummings, {Oscar W.} and Lydia Lee and Linda Ragozzino and Raj Vuppalanchi and Elizabeth Byam and Ann Klipsch and Girish Subbarao and Kimberly Pfeifer and Ann Scheimann and Michael Torbenson and Sarah Barlow and Jose Derdoy and Joyce Hoffmann and Debra King and Andrea Morris",
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AU - the NASH CRN Research Group

AU - Vos, Miriam B.

AU - Colvin, Ryan

AU - Belt, Patricia

AU - Molleston, Jean P.

AU - Murray, Karen F.

AU - Rosenthal, Philip

AU - Schwimmer, Jeffrey

AU - Tonascia, James

AU - Unalp, Aynur

AU - Lavine, Joel E.

AU - Abrams, Stephanie

AU - Arceo, Diana

AU - Espinosa, Denise

AU - Fairly, Leanel Angeli

AU - Hawkins, Carol

AU - Liu, Yao Chang

AU - Stager, Margaret

AU - McCullough, Arthur

AU - Dasarathy, Srinivasan

AU - Sargent, Ruth

AU - Coffey, Melissa

AU - Young, Melissa

AU - Mohan, Parvathi

AU - Nair, Kavita

AU - Abdelmalek, Manal

AU - Diehl, Anna Mae

AU - Gottfried, Marcia

AU - Guy, Cynthia

AU - Killenberg, Paul

AU - Kwan, Samantha

AU - Pan, Yi Ping

AU - Piercy, Dawn

AU - Smith, Melissa

AU - Bhimalli, Prajakta

AU - Chalasani, Naga

AU - Cummings, Oscar W.

AU - Lee, Lydia

AU - Ragozzino, Linda

AU - Vuppalanchi, Raj

AU - Byam, Elizabeth

AU - Klipsch, Ann

AU - Subbarao, Girish

AU - Pfeifer, Kimberly

AU - Scheimann, Ann

AU - Torbenson, Michael

AU - Barlow, Sarah

AU - Derdoy, Jose

AU - Hoffmann, Joyce

AU - King, Debra

AU - Morris, Andrea

PY - 2012/1/1

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N2 - Objectives - 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. Methods - 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. Results - 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). Conclusions - 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.

AB - Objectives - 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. Methods - 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. Results - 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). Conclusions - 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.

KW - nonalcoholic steatohepatitis

KW - nutrition

KW - sugar-sweetened beverages

KW - vitamin C

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