Pediatric Nonalcoholic Fatty Liver Disease: the Rise of a Lethal Disease Among Mexican American Hispanic Children

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• 作者：Monica M. Betancourt-Garcia ; Armando Arguelles ; Jorge Montes…
• 关键词：Pediatric nonalcoholic fatty liver disease ; PNPLA3 ; Mexican American ; Gut microbiome ; Epidemiology ; Hepatic steatosis
• 刊名：Obesity Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：27
• 期：1
• 页码：236-244
• 全文大小：
• 刊物主题：Surgery;
• 出版者：Springer US
• ISSN：1708-0428
• 卷排序：27

文摘

Hispanic children of Mexican origin have a high incidence of NAFLD. Susceptibility has been linked to a combination of factors including an increasing epidemic of obesity in children and adolescents, an allele substitution in the PNPLA3 gene that reduces hepatic lipid catabolism, and an altered microbiome that may increase hepatic endotoxins. The combination of NAFLD and portal vein toxins secondary to an indigenous gut microbiome appear to lead to the early occurrence of NASH, which progresses to cirrhosis and early hepatocellular carcinoma. Early detection and treatment of hepatic changes are needed. Given the success of gastric bypass in reducing body weight, modifying the gut microbiome, and improving NAFLD/NASH in adults, a trial of gastric bypass in predisposed pediatric candidates should be undertaken.