• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.sup1
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• pp.62-71
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• 2009

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Similar to NAFLD in adults, NAFLD in children is associated with obesity and insulin resistance and requires liver histology for diagnosis and staging. However, significant histological differences exist between adult and pediatric NAFLD. The rise in childhood obesity has been accompanied by an increase in pediatric NAFLD. Age, gender and race/ethnicity are significant determinants of risk, and sex hormones, insulin sensitivity and adipocytokines are implicated in the pathogenesis of pediatric NAFLD. There is no consensus for treatment of NAFLD, however, data suggest that diet, exercise and some pharmacological therapies may be of benefit. To evaluate and effectively treat pediatric NAFLD, the pathophysiology and natural history of the disease should be clarified and non-invasive methods for screening, diagnosis, and longitudinal assessment developed.

• The Korean Journal of Physiology and Pharmacology
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• v.27 no.4
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• pp.299-310
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• 2023

Non-alcoholic fatty liver disease (NAFLD) is a complex disorder characterized by the accumulation of fat in the liver in the absence of excessive alcohol consumption. It is one of the most common liver diseases worldwide, affecting approximately 25% of the global population. It is closely associated with obesity, type 2 diabetes, and metabolic syndrome. Moreover, NAFLD can progress to non-alcoholic steatohepatitis, which can cause liver cirrhosis, liver failure, and hepatocellular carcinoma. Currently, there are no approved drugs for the treatment of NAFLD. Therefore, the development of effective drugs is essential for NAFLD treatment. In this article, we discuss the experimental models and novel therapeutic targets for NAFLD. Additionally, we propose new strategies for the development of drugs for NAFLD.

• The Journal of Korean Medicine
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• v.32 no.3
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• pp.44-49
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• 2011

Objective: This study aimed to get information on the current status of therapies to date for non-alcoholic fatty liver disease (NAFLD), including non-alcoholic steatohepatitis (NASH). Methods: All randomized clinical controlled trial (RCT)-derived papers for NAFLD or NASH were reviewed via PubMed Database. Results: 39 RCTs met the review criteria, of which 15 and 24 papers were for NAFLD and NASH, respectively. 83% of the papers were released since 2006, and 30 studies were conducted for western medicines, antioxidants and lifestyle intervention whereas nine trials were done using herbal medicine or acupuncture which showed positive outcome. Conclusions: NAFLD and NASH are new epidemic disorders which can be a target of traditional Oriental medicine. This study will be helpful for the Oriental medicine-based strategies or therapeutic development for them.

• The Journal of Internal Korean Medicine
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• v.32 no.1
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• pp.26-32
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• 2011

Objectives : Non-alcoholic fatty liver disease (NAFLD) is known to be increasing and becoming a health-related issue worldwide. This study aimed to analyze its prevalence and characterize NAFLD. Methods : NAFLD-related papers were surveyed via PubMed and in Korean medical journals, and then the prevalence and pathology were reviewed. Results : The prevalence of NAFLD in the general population is around 10~30% worldwide. The prevalence of NAFLD in Korea is estimated as 15~30%, which is higher than in China and Japan. The most important etiological-factors of NAFLD include central obesity resulting from excessive calorie intake and less physical activity, which lead to adiponectin hypoactivity and insulin resistance. The Oriental medicine view point of NAFLD pathology is phlegm-dampness by dysfunction of free flow in liver. Conclusions : This study provided an overview of the prevalence and pathology of NAFLD, and can support the development of a strategy for traditional Korean medicine-based prevention or treatment of NAFLD.

• Biomedical Science Letters
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• v.14 no.4
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• pp.225-231
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• 2008

Non-alcoholic fatty liver disease (NAFLD) is associated with various metabolic abnormalities, including central obesity, type 2 diabetes, dyslipidemia, and high blood pressure. This suggests that NAFLD may represent the hepatic manifestation of the metabolic syndrome. In this study, we investigated unfavorable effects NAFLD on components of metabolic syndrome in post-menopause women. Eight hundred sixty-nine postmenopausal women were recruited for this study. The diagnosis of fatty liver was based on the results of abdominal ultrasonography. Serum levels of fasting glucose, total cholesterol, triglyceride, and HDL-cholesterol were measured. The prevalence of component of metabolic syndrome such as hypertension, hyperglycemia, hypertriglyceridemia, and low-HDL-cholesterol was significantly higher in subjects with NAFLD as compared with those without NAFLD. The moderate to severe grade of NAFLD presented higher levels of serum fasting glucose, fasting insulin, HOMA-IR, total cholesterol, and triglycerides than the mild NAFLD and the normal group. In conclusion, metabolic syndrome risk was increased in post-menopause women with NAFLD as compared with those without NAFLD. The severity of NAFLD affected metabolic syndrome risk factors. The optimal strategy for the treatment of NAFLD is likely to include lifestyle modifications and therapy to improve insulin resistance.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.276-285
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• 2020

Purpose: Non-alcoholic fatty liver disease (NAFLD) ranges in severity from simple steatosis to steatohepatitis. Early detection of NAFLD is important for preventing the disease from progressing to become an irreversible end-stage liver disease. We developed a nomogram that allows for non-invasive screening for NAFLD in obese children. Methods: Anthropometric and laboratory data of 180 patients from our pediatric obesity clinic were collected. Diagnoses of NAFLD were based on abdominal ultrasonographic findings. The nomogram was constructed using predictors from a multivariate analysis of NAFLD risk factors. Results: The subjects were divided into non-NAFLD (n=67) and NAFLD groups (n=113). Factors, including sex, body mass index, abdominal circumference, blood pressure, insulin resistance, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γGT), uric acid, triglycerides, and insulin, were significantly different between the two groups (all p<0.05) as determined using homeostatis model assessment of insulin resistance (HOMA-IR). In our multivariate logistic regression analysis, elevated serum ALT, γGT, and triglyceride levels were significantly related to NAFLD development. The nomogram was established using γGT, uric acid, triglycerides, HOMA-IR, and ALT as predictors of NAFLD probability. Conclusion: The newly developed nomogram may help predict NAFLD risk in obese children. The nomogram may also allow for early NAFLD diagnosis without the need for invasive liver biopsy or expensive liver imaging, and may also allow clinicians to intervene early to prevent the progression of NAFLD to become a more advanced liver disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.5
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• pp.470-478
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• 2019

Purpose: The incidence of non-alcoholic fatty liver disease (NAFLD) in children is gradually increasing. The aim of this study was to investigate the use of serum adiponectin and soluble adiponectin receptor 2 (soluble Adipo R2) levels for the diagnosis of fatty liver disease in obese and overweight children. Methods: The study included 51 obese and overweight children between the ages of 6 and 18 years diagnosed with NAFLD using ultrasonography and 20 children without fatty liver disease. Patients whose alanine transaminase level was two times higher than normal (${\geq}80U/L$) were included in the non-alcoholic steatohepatitis (NASH) group. Results: NASH was observed in 11 (21.6%) of the patients with NAFLD. The incidence of obesity was higher in patients with NASH (80% and 45%, p=0.021). While the adiponectin levels were similar in patients with NAFLD and those without, they were below the normal level in the whole study group. Adiponectin and soluble Adipo R2 levels of patients with NASH were lower than those in patients without NASH; however, this difference was not statistically significant (p=0.064 and p=0.463). Soluble Adipo R2 levels in obese patients with NAFLD were higher than those in obese children without NAFLD (p<0.001). Conclusion: Soluble adiponectin receptor 2 level is a noninvasive marker that can be used for the diagnosis of NAFLD in obese children.

• Nutrition Research and Practice
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• v.12 no.2
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• pp.110-117
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• 2018

BACKGROUND/OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease and is closely associated with metabolic syndrome. In the present study, we observed the effect of ethanol extract of Allium fistulosum (EAF) on NAFLD and have suggested the possibility of using EAF as a natural product for application in the development of a treatment for NAFLD. MATERIALS/METHODS: The preventive effect on hepatic lipid accumulation was estimated by using an oleic acid (OA)-induced NAFLD model in vitro and a Western diet (high-fat high-sucrose; WD)-induced obese mouse model. Animals were divided into three groups (n = 7): normal diet group (ND), WD group, and WD plus 1% EAF group. RESULTS: EAF reduced OA-stimulated lipid accumulation in HepG2 cells in the absence of cellular cytotoxicity and significantly blocked transcriptional activation of sterol regulatory element-binding protein 1 and fatty acid synthase genes. Subsequently, we investigated these effects in vivo in mice fed either ND or WD in the presence or absence of EAF supplementation. In comparison to the ND controls, the WD-fed mice exhibited increases in body weight, liver weight, epididymal fat weight, and accumulation of fat in hepatocytes, and these effects were significantly attenuated by EAF supplementation. CONCLUSIONS: Allium fistulosum attenuates the development of NAFLD, and EAF elicits anti-lipogenic activity in liver. Therefore, EAF represents a promising candidate for use in the development of novel therapeutic drugs or drug combinations for the prevention and treatment of NAFLD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.5
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• pp.443-454
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• 2021

Purpose: Due to the increasing prevalence of obesity worldwide, non-alcoholic fatty liver disease (NAFLD) has reached epidemic dimensions over time. NAFLD is the most common cause of childhood chronic liver disease. There is a relationship between NAFLD and oxidative stress. This study aims to investigate the changes in thiol/disulfide homeostasis parameters to determine the oxidant/antioxidant balance in obese rats with diet-induced NAFLD and healthy rats. Methods: Twelve Wistar albino rats were used in this study. Experimentally produced NAFLD obese rats (n=6) and healthy rats were compared. Experimental NAFLD model was created with a special fatty liver diet (Altromin^® C1063, Fatty Liver Diet, Exclusivet, Lage, Germany). The biochemical and histopathological features of the groups, as well as serum thiol/disulfide homeostasis parameters, were analyzed and compared. Results: In the experimentally induced NAFLD rat model, they gained more weight than the control group. Steatosis (at least grade 2) occurred in all rats fed with special fatty liver diet for 12 weeks. Histopathologically, no high-grade inflammation was observed in rats with experimental NAFLD after feeding a diet for 12 weeks. Results revealed that aspartate transaminase and alanine transaminase levels were high, albumin levels were low, oxidant stress parameters increased, and antioxidant thiol groups decreased. Conclusion: Experimental NAFLD is characterized by increased oxidant stress accompanying fatty tissue in the liver. Analysis of thiol/disulfide homeostasis parameters in NAFLD can be used in further studies to develop effective treatment options.

• Clinical and Molecular Hepatology
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• v.24 no.4
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• pp.392-401
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• 2018

Background/Aims: Leptin is associated with metabolic disorders, which predispose one to non-alcoholic fatty liver disease (NAFLD). The role of leptin in NAFLD pathogenesis is not fully understood. We aim to investigate the association between serum leptin level and severity of NAFLD using U.S. nationally representative data. Methods: Data were obtained from the United States Third National Health and Nutrition Examination Survey. NAFLD was defined by ultrasound detection and severity of hepatic steatosis in the absence of other liver diseases. The severity of hepatic fibrosis was determined by NAFLD fibrosis score (NFS). We used multivariate survey-weighted generalized logistic regression to evaluate the association between leptin level and the degree of NAFLD. We also performed subgroup analyses by body mass index (lean vs. classic NAFLD). Results: Among 4,571 people, 1,610 (35%) had NAFLD. By ultrasound findings, there were 621 people with mild, 664 with moderate, and 325 with severe steatosis. There were 885 people with low NFS (<-1.455, no significant fibrosis), 596 with intermediate NFS, and 129 with high NFS (>0.676, advanced fibrosis). Leptin levels for normal, mild, moderate and severe steatosis were $10.7{\pm}0.3ng/mL$, $12.1{\pm}0.7ng/mL$, $15.6{\pm}0.8ng/mL$, $16{\pm}1.0ng/mL$, respectively (trend P-value<0.001). Leptin levels for low, intermediate, and high NFS were $11.8{\pm}0.5ng/mL$, $15.6{\pm}0.8ng/mL$, $28.5{\pm}3.5ng/mL$, respectively (trend P-value<0.001). This association remained significant even after adjusting for known demographic and metabolic risk factors. In the subgroup analysis, this association was only prominent in classic NAFLD, but not in lean NAFLD. Conclusions: Serum leptin level is associated with the severity of NAFLD, especially in classic NAFLD patients.