Analysis of Risk Factors for Fatty Liver Disease in Children with Wilson's Disease

Overview

Journal Eur J Gastroenterol Hepatol

Specialty Gastroenterology

Date 2024 Jun 14

PMID 38874972

Authors

Shu-Pei Jia

Mei-Xia Wang

Zhuang Tao

Yan-Nan Gao

Gu-Ran Yu

Wen-Ming Yang

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Many children with Wilson's disease are complicated with dyslipidemia. The aim of this study was to investigate the risk factors for the development of fatty liver disease (FLD) in children with Wilson's disease.

Methods: We evaluated sex, age, weight, the disease course, treatment course, clinical classification, alanine transaminase (ALT), aspartate transaminase, γ-glutamyl transpeptidase, total biliary acid, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, homocysteine, uric acid, fibrinogen (FBG), creatinine, procollagen III N-terminal propeptide, laminin, hyaluronic acid, type IV collagen, and performed receiver operating characteristic curve analysis to investigate the forecast value of individual biochemical predictors and combined predictive indicators to evaluate FLD in Wilson's disease.

Results: The multivariate logistic regression analysis revealed that ALT [odds ratio (OR), 1.011; 95% confidence interval (CI), 1.004-1.02; P = 0.006], uric acid (OR, 1.01; 95% CI, 1.002-1.018; P = 0.017), FBG (OR, 3.668; 95% CI, 1.145-13.71; P = 0.037), creatinine (OR, 0.872; 95% CI, 0.81-0.925; P < 0.001), and laminin (OR, 1.01; 95% CI, 1.002-1.018; P = 0.017) acted as independent risk factors in Wilson's disease complicated with FLD. The receiver operating characteristic curves for combined predictive indicators demonstrated an area under the curve values of 0.872, which was found to be a significant predictors for FLD in Wilson's disease.

Conclusions: We screened out the most important risk factors, namely ALT, uric acid, creatinine, FBG, and laminin for Wilson's disease complicated with FLD. The joint prediction achieved is crucial for identifying children with Wilson's disease complicated with FLD.

References

Seo Y, Han A . Association of the Serum Uric Acid-to-Creatinine Ratio with Nonalcoholic Fatty Liver Disease Diagnosed by Computed Tomography. Metab Syndr Relat Disord. 2020; 19(2):70-75. DOI: 10.1089/met.2020.0086. View

Riazi K, Azhari H, Charette J, Underwood F, King J, Afshar E . The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022; 7(9):851-861. DOI: 10.1016/S2468-1253(22)00165-0. View

Pronicki M . Wilson disease - liver pathology. Handb Clin Neurol. 2017; 142:71-75. DOI: 10.1016/B978-0-444-63625-6.00007-0. View

Wan X, Xu C, Lin Y, Lu C, Li D, Sang J . Uric acid regulates hepatic steatosis and insulin resistance through the NLRP3 inflammasome-dependent mechanism. J Hepatol. 2015; 64(4):925-32. DOI: 10.1016/j.jhep.2015.11.022. View

Taylor A, Siddiqui M, Ambery P, Armisen J, Challis B, Haefliger C . Metabolic dysfunction-related liver disease as a risk factor for cancer. BMJ Open Gastroenterol. 2022; 9(1). PMC: 8961105. DOI: 10.1136/bmjgast-2021-000817. View

DiStefano J . NAFLD and NASH in Postmenopausal Women: Implications for Diagnosis and Treatment. Endocrinology. 2020; 161(10). PMC: 7473510. DOI: 10.1210/endocr/bqaa134. View

Gottlieb A, Dev S, DeVine L, Gabrielson K, Cole R, Hamilton J . Hepatic Steatosis in the Mouse Model of Wilson Disease Coincides with a Muted Inflammatory Response. Am J Pathol. 2021; 192(1):146-159. PMC: 8759043. DOI: 10.1016/j.ajpath.2021.09.010. View

Abrams G, Rabil A, Williams A, Hecht E . Serum Alanine Transaminase Is an Inadequate Nonalcoholic Fatty Liver Screening Test in Adolescents: Results From the National Health and Nutrition Examination Survey 2017-2018. Clin Pediatr (Phila). 2021; 60(8):370-375. DOI: 10.1177/00099228211020177. View

. [Guidelines of prevention and treatment for nonalcoholic fatty liver disease: a 2018 update]. Zhonghua Gan Zang Bing Za Zhi. 2018; 26(3):195-203. DOI: 10.3760/cma.j.issn.1007-3418.2018.03.008. View

10.

Wang L, Sun L, Huang J, Chen G, Zhao X . [A clinicopathological analysis of 21 cases of hepatolenticular degeneration]. Zhonghua Gan Zang Bing Za Zhi. 2019; 26(12):903-908. DOI: 10.3760/cma.j.issn.1007-3418.2018.12.006. View

11.

Wattacheril J, Shea P, Mohammad S, Behling C, Aggarwal V, Wilson L . Exome sequencing of an adolescent with nonalcoholic fatty liver disease identifies a clinically actionable case of Wilson disease. Cold Spring Harb Mol Case Stud. 2018; 4(5). PMC: 6169823. DOI: 10.1101/mcs.a003087. View

12.

Ferenci P, Stremmel W, Czlonkowska A, Szalay F, Viveiros A, Stattermayer A . Age and Sex but Not ATP7B Genotype Effectively Influence the Clinical Phenotype of Wilson Disease. Hepatology. 2018; 69(4):1464-1476. DOI: 10.1002/hep.30280. View

13.

Tang Y, Xu Y, Liu P, Liu C, Zhong R, Yu X . No Evidence for a Causal Link between Serum Uric Acid and Nonalcoholic Fatty Liver Disease from the Dongfeng-Tongji Cohort Study. Oxid Med Cell Longev. 2022; 2022:6687626. PMC: 8941576. DOI: 10.1155/2022/6687626. View

14.

Hegarty R, Singh S, Bansal S, Fitzpatrick E, Dhawan A . NAFLD to MAFLD in adults but the saga continues in children: an opportunity to advocate change. J Hepatol. 2021; 74(4):991-992. DOI: 10.1016/j.jhep.2020.12.032. View

15.

Fanni D, Fanos V, Gerosa C, Piras M, Dessi A, Atzei A . Effects of iron and copper overload on the human liver: an ultrastructural study. Curr Med Chem. 2014; 21(33):3768-74. DOI: 10.2174/0929867321666140601163244. View

16.

Gu Y, Zhang W, Hu Y, Chen Y, Shi J . Association between nonalcoholic fatty liver disease and depression: A systematic review and meta-analysis of observational studies. J Affect Disord. 2022; 301:8-13. DOI: 10.1016/j.jad.2021.12.128. View

17.

Umano G, Grandone A, Di Sessa A, Cozzolino D, Pedulla M, Marzuillo P . Pediatric obesity-related non-alcoholic fatty liver disease: waist-to-height ratio best anthropometrical predictor. Pediatr Res. 2020; 90(1):166-170. DOI: 10.1038/s41390-020-01192-w. View

18.

Zhou L, Zhang L, Zhang L, Yi W, Yu X, Mei H . Analysis of risk factors for non-alcoholic fatty liver disease in hospitalized children with obesity before the late puberty stage. Front Endocrinol (Lausanne). 2023; 14:1224816. PMC: 10501779. DOI: 10.3389/fendo.2023.1224816. View

19.

Kamada Y, Kiso S, Yoshida Y, Chatani N, Kizu T, Hamano M . Estrogen deficiency worsens steatohepatitis in mice fed high-fat and high-cholesterol diet. Am J Physiol Gastrointest Liver Physiol. 2011; 301(6):G1031-43. DOI: 10.1152/ajpgi.00211.2011. View

20.

Vos M, Abrams S, Barlow S, Caprio S, Daniels S, Kohli R . NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children: Recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology.... J Pediatr Gastroenterol Nutr. 2017; 64(2):319-334. PMC: 5413933. DOI: 10.1097/MPG.0000000000001482. View