Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents

JOURNAL OF HEPATOLOGY

卷:66

Article

Mosca, Antonella¹  Nobili, Valerio^1,2  De Vito, Rita²  Crudele, Annalisa³  Scorletti, Eleonora^4,5,6  Villani, Alberto⁷  Alisi, Anna³  Byrne, Christopher D.^4,5,6 

[1] Bambino Gesu Pediat Hosp, Hepatometab Unit, I-00165 Rome, Italy

[2] Bambino Gesu Pediat Hosp, IRCCS, Histopathol Unit, Rome, Italy

[3] Bambino Gesu Pediat Hosp, Liver Res Unit, Rome, Italy

[4] Univ Southampton, Fac Med, Human Dev & Hlth Acad Unit, Southampton, Hants, England

[5] Univ Hosp Southampton NHS Fdn Trust, NIHR Southampton Biomed Res Ctr, Southampton, Hants, England

[6] Univ Southampton, Southampton, Hants, England

[7] Bambino Gesu Children Hosp, IRCCS, Paediat & Infect Dis, Rome, Italy

关键词: Uric acid;    Fructose consumption;    Non-alcoholic fatty liver disease (NAFLD);    Non-alcoholic steatohepatitis (NASH);    Obesity;    Fructose;    Child;    Diet;    Adolescent;    Hyperuricemia;   

DOI  :  10.1016/j.jhep.2016.12.025

来源: Elsevier

【 摘 要 】

Background & Aims: Recent research has suggested that dietary fructose intake may increase serum uric acid (UA) concentrations. Both UA concentration and fructose consumption maybe also increase in NAFLD. It is not known whether dietary fructose consumption and UA concentration are independently associated with non-alcoholic steatohepatitis (NASH). Our aim was to investigate the factors associated with NASH in children and adolescents with proven NAFLD, and to test whether UA concentrations and fructose consumption are independently associated with NASH. Methods: Obese children with NAFLD were studied (n = 271). NASH was diagnosed by a NAFLD activity score >= 5 and the fatty liver inhibition of progression (FLIP) algorithm. Fructose consumption (g/day) was assessed by food frequency questionnaire, and UA (mg/dl) was measured in serum. Binary logistic regression with adjustment for covariates and potential confounders was undertaken to test factors independently associated with NASH. Results: NASH occurred in 37.6% of patients. Hyperuricaemia (UA >= 5.9 mg/dl) was present in 47% of patients with NASH compared with 29.7% of non-NASH patients (p = 0.003). Both UA concentration (OR = 2.488, 95% CI: 1.87-2.83, p = 0.004) and fructose consumption (OR = 1.612, 95% CI 1.25-1.86, p = 0.001) were independently associated with NASH, after adjustment for multiple (and all) measured confounders. Fructose consumption was independently associated with hyperuricaemia (OR = 2.021, 95% CI: 1.66-2.78, p = 0.01). These data were confirmed using the FLIP algorithm. Conclusions: Both dietary fructose consumption and serum UA concentrations are independently associated with NASH. Fructose consumption was the only factor independently associated with serum UA concentration. Lay summary: Currently, it is not known whether dietary fructose consumption and uric acid (UA) concentration are linked with non-alcoholic steatohepatitis (NASH) in children and adolescents. Our aim was to test whether UA concentrations and fructose consumption are independently associated with NASH in children and adolescents with proven non-alcoholic fatty liver disease (NAFLD). We show that both dietary fructose consumption and serum UA concentrations are independently associated with NASH and fructose consumption was independently linked with high serum UA concentrations. (C) 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

【 授权许可】

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