Improvement in liver histology is associated with reduction in dyslipidemia in children with nonalcoholic fatty liver disease

Kathleen E. Corey, Raj Vuppalanchi, Miriam Vos, Rohit Kohli, Jean Molleston, Laura Wilson, Aynur Unalp-Arida, Oscar Cummings, Joel E. Lavine, Naga Chalasani

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objectives: Nonalcoholic fatty liver disease (NAFLD), the most common cause of liver disease among US children, may be associated with cardiovascular disease (CVD) risk. The present study sought to determine the prevalence of dyslipidemia in children with NAFLD and assess dyslipidemia by liver histology and histologic changes. Methods: Individuals in the Treatment of NAFLD in Children (TONIC) trial were included (N=173). In the TONIC trial, children with NAFLD were randomized to vitamin E, metformin, or placebo for 96 weeks. Nonalcoholic steatohepatitis (NASH) improved in 56 children. Change in lipid levels from baseline and 96 weeks was compared between patients with and without histologic improvement and with and without NASH. Results: Dyslipidemia was frequent, with low high-density lipoprotein (HDL) (3.0 in 57.2% of patients. Histologic improvement was associated with significant decreases in cholesterol (-11.4 mg/dL vs -1.9 mg/dL, P=0.04), LDL (-11.2 mg/dL vs -2.1 mg/dL, P=0.04), and non-HDL-C (-8.8 mg/dL vs 0.5 mg/dL, P=0.03) compared with those without improvement. Children with NASH resolution had significant decreases in cholesterol (-10.0 mg/dL vs -0.9 mg/dL, P=0.02) and non-HDL-C (-7.3 mg/dL vs 1.1 mg/dL, P=0.01) compared with those without NASH resolution. There was no improvement in triglycerides, HDL level, or triglycerides/HDL ratio in either group. Conclusions: Dyslipidemia is frequent in children with NAFLD. NASH resolution and histologic improvement are associated with improvements in some forms of dyslipidemia.

Original languageEnglish (US)
Pages (from-to)360-367
Number of pages8
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume60
Issue number3
DOIs
StatePublished - Mar 7 2015

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Dyslipidemias
Histology
Liver
HDL Lipoproteins
Lipoproteins
Triglycerides
Non-alcoholic Fatty Liver Disease
Cholesterol
Metformin
Vitamin E
LDL Lipoproteins
Liver Diseases
Cardiovascular Diseases
Placebos
Lipids

Keywords

  • cardiovascular disease risk
  • lipids
  • metformin
  • non-high-density lipoprotein cholesterol
  • nonalcoholic fatty liver disease
  • nonalcoholic steatohepatitis

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

Cite this

Improvement in liver histology is associated with reduction in dyslipidemia in children with nonalcoholic fatty liver disease. / Corey, Kathleen E.; Vuppalanchi, Raj; Vos, Miriam; Kohli, Rohit; Molleston, Jean; Wilson, Laura; Unalp-Arida, Aynur; Cummings, Oscar; Lavine, Joel E.; Chalasani, Naga.

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 60, No. 3, 07.03.2015, p. 360-367.

Research output: Contribution to journalArticle

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title = "Improvement in liver histology is associated with reduction in dyslipidemia in children with nonalcoholic fatty liver disease",
abstract = "Objectives: Nonalcoholic fatty liver disease (NAFLD), the most common cause of liver disease among US children, may be associated with cardiovascular disease (CVD) risk. The present study sought to determine the prevalence of dyslipidemia in children with NAFLD and assess dyslipidemia by liver histology and histologic changes. Methods: Individuals in the Treatment of NAFLD in Children (TONIC) trial were included (N=173). In the TONIC trial, children with NAFLD were randomized to vitamin E, metformin, or placebo for 96 weeks. Nonalcoholic steatohepatitis (NASH) improved in 56 children. Change in lipid levels from baseline and 96 weeks was compared between patients with and without histologic improvement and with and without NASH. Results: Dyslipidemia was frequent, with low high-density lipoprotein (HDL) (3.0 in 57.2{\%} of patients. Histologic improvement was associated with significant decreases in cholesterol (-11.4 mg/dL vs -1.9 mg/dL, P=0.04), LDL (-11.2 mg/dL vs -2.1 mg/dL, P=0.04), and non-HDL-C (-8.8 mg/dL vs 0.5 mg/dL, P=0.03) compared with those without improvement. Children with NASH resolution had significant decreases in cholesterol (-10.0 mg/dL vs -0.9 mg/dL, P=0.02) and non-HDL-C (-7.3 mg/dL vs 1.1 mg/dL, P=0.01) compared with those without NASH resolution. There was no improvement in triglycerides, HDL level, or triglycerides/HDL ratio in either group. Conclusions: Dyslipidemia is frequent in children with NAFLD. NASH resolution and histologic improvement are associated with improvements in some forms of dyslipidemia.",
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author = "Corey, {Kathleen E.} and Raj Vuppalanchi and Miriam Vos and Rohit Kohli and Jean Molleston and Laura Wilson and Aynur Unalp-Arida and Oscar Cummings and Lavine, {Joel E.} and Naga Chalasani",
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T1 - Improvement in liver histology is associated with reduction in dyslipidemia in children with nonalcoholic fatty liver disease

AU - Corey, Kathleen E.

AU - Vuppalanchi, Raj

AU - Vos, Miriam

AU - Kohli, Rohit

AU - Molleston, Jean

AU - Wilson, Laura

AU - Unalp-Arida, Aynur

AU - Cummings, Oscar

AU - Lavine, Joel E.

AU - Chalasani, Naga

PY - 2015/3/7

Y1 - 2015/3/7

N2 - Objectives: Nonalcoholic fatty liver disease (NAFLD), the most common cause of liver disease among US children, may be associated with cardiovascular disease (CVD) risk. The present study sought to determine the prevalence of dyslipidemia in children with NAFLD and assess dyslipidemia by liver histology and histologic changes. Methods: Individuals in the Treatment of NAFLD in Children (TONIC) trial were included (N=173). In the TONIC trial, children with NAFLD were randomized to vitamin E, metformin, or placebo for 96 weeks. Nonalcoholic steatohepatitis (NASH) improved in 56 children. Change in lipid levels from baseline and 96 weeks was compared between patients with and without histologic improvement and with and without NASH. Results: Dyslipidemia was frequent, with low high-density lipoprotein (HDL) (3.0 in 57.2% of patients. Histologic improvement was associated with significant decreases in cholesterol (-11.4 mg/dL vs -1.9 mg/dL, P=0.04), LDL (-11.2 mg/dL vs -2.1 mg/dL, P=0.04), and non-HDL-C (-8.8 mg/dL vs 0.5 mg/dL, P=0.03) compared with those without improvement. Children with NASH resolution had significant decreases in cholesterol (-10.0 mg/dL vs -0.9 mg/dL, P=0.02) and non-HDL-C (-7.3 mg/dL vs 1.1 mg/dL, P=0.01) compared with those without NASH resolution. There was no improvement in triglycerides, HDL level, or triglycerides/HDL ratio in either group. Conclusions: Dyslipidemia is frequent in children with NAFLD. NASH resolution and histologic improvement are associated with improvements in some forms of dyslipidemia.

AB - Objectives: Nonalcoholic fatty liver disease (NAFLD), the most common cause of liver disease among US children, may be associated with cardiovascular disease (CVD) risk. The present study sought to determine the prevalence of dyslipidemia in children with NAFLD and assess dyslipidemia by liver histology and histologic changes. Methods: Individuals in the Treatment of NAFLD in Children (TONIC) trial were included (N=173). In the TONIC trial, children with NAFLD were randomized to vitamin E, metformin, or placebo for 96 weeks. Nonalcoholic steatohepatitis (NASH) improved in 56 children. Change in lipid levels from baseline and 96 weeks was compared between patients with and without histologic improvement and with and without NASH. Results: Dyslipidemia was frequent, with low high-density lipoprotein (HDL) (3.0 in 57.2% of patients. Histologic improvement was associated with significant decreases in cholesterol (-11.4 mg/dL vs -1.9 mg/dL, P=0.04), LDL (-11.2 mg/dL vs -2.1 mg/dL, P=0.04), and non-HDL-C (-8.8 mg/dL vs 0.5 mg/dL, P=0.03) compared with those without improvement. Children with NASH resolution had significant decreases in cholesterol (-10.0 mg/dL vs -0.9 mg/dL, P=0.02) and non-HDL-C (-7.3 mg/dL vs 1.1 mg/dL, P=0.01) compared with those without NASH resolution. There was no improvement in triglycerides, HDL level, or triglycerides/HDL ratio in either group. Conclusions: Dyslipidemia is frequent in children with NAFLD. NASH resolution and histologic improvement are associated with improvements in some forms of dyslipidemia.

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KW - lipids

KW - metformin

KW - non-high-density lipoprotein cholesterol

KW - nonalcoholic fatty liver disease

KW - nonalcoholic steatohepatitis

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