Portal inflammation in children with nonalcoholic fatty liver disease is associated with more than a threefold greater risk of more advanced fibrosis, according to a paper published in Hepatology.
A cross-sectional study in 430 children with nonalcoholic fatty liver disease – 12% with type 1 disease, 22% with type 2, and 66% with an overlap of both – found that the presence of portal inflammation was associated with a significant independent association with stage 2-4 fibrosis (odds ratio, 3.70; 95% confidence interval, 1.40-5.21; P = .003), after adjustment for age and sex.
Courtesy of ICL2015
Dr. Jake Mann
Stage 2-4 fibrosis was associated with a greater incidence of steatosis (OR, 1.81; P less than .0001), lobular inflammation (OR, 1.40; P less than .0001) and a twofold greater incidence of ballooning (P less than .0001).
While children with type 2 or overlap nonalcoholic fatty liver disease typically had lower alanine aminotransferase, aspartate aminotransferase, and bilirubin scores than those with type 1, they had a higher adjusted body mass index and waist circumference, lower HDL cholesterol and higher triglycerides (Hepatology. March 2016;63:745-53).
“Our data highlight that patients with type 2 and overlap NAFLD, in particular portal inflammation and high BMI or waist circumference, may be at increased risk of hepatic or metabolic complications,” wrote Dr. Jake P. Mann from the University of Cambridge, England, and his coauthors, suggesting that an elevated waist circumference could serve as a noninvasive indicator of risk of portal inflammation and fibrosis.
No conflicts of interest were declared.
