Metabolic Dysfunction-Associated Steatotic Liver Disease in an Urban Paediatric Cohort With High Socioeconomic Deprivation.

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity Pub Date : 2025-07-05 DOI:10.1111/ijpo.70037

Christine Brichta, Ariel Porto, Mark Fishbein, Saeed Mohammad, Catherine A Chapin

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引用次数: 0

Abstract

Background: Whether higher socioeconomic deprivation indices are associated with more severe paediatric metabolic dysfunction-associated steatotic liver disease (MASLD), formerly non-alcoholic fatty liver disease (NAFLD), remains unknown.

Objective: We aimed to evaluate differences in MASLD characteristics and social deprivation in a cohort of urban children.

Methods: Retrospective study of 277 paediatric patients ≤ 18 years old evaluated between January 2009 and December 2019 with a suspected diagnosis of MASLD who underwent liver biopsy. Patients were classified as having metabolic dysfunction-associated steatohepatitis (MASH) based on their NAFLD Activity Score (NAS). Fibrosis was determined based on biopsy presence. Social deprivation index (SDI) scores were calculated using patient address.

Results: Patients were predominantly Hispanic males with obesity and a median age of 12 years. Median SDI score was 85 (65-93). Median ALT was significantly higher in patients with MASH compared with MASLD (136 vs. 92 IU/L, p < 0.001) or with fibrosis compared with no fibrosis (120 vs. 68 IU/L, p < 0.001). High SDI group patients had a significantly higher median AST (60 vs. 47 IU/L, p = 0.022), NAS score (4 vs. 3, p = 0.026) and rates of bridging fibrosis (24% vs. 10%, p = 0.023) compared with the lower SDI group.

Conclusion: Within a cohort of predominantly Hispanic children with MASLD and high socioeconomic disadvantage, there are significant laboratory and histologic differences in patients with higher SDI scores, suggesting increased MASLD severity.

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高社会经济剥夺的城市儿童队列中代谢功能障碍相关的脂肪变性肝病

背景：较高的社会经济剥夺指数是否与更严重的儿童代谢功能障碍相关的脂肪变性肝病（MASLD），即以前的非酒精性脂肪性肝病（NAFLD）相关，尚不清楚。目的：我们旨在评估城市儿童MASLD特征和社会剥夺的差异。方法：回顾性研究2009年1月至2019年12月期间277例≤18岁的疑似MASLD的儿科患者，这些患者接受了肝活检。根据患者的NAFLD活动评分（NAS），将患者分类为代谢功能障碍相关脂肪性肝炎（MASH）。纤维化是根据活检的存在来确定的。社会剥夺指数（SDI）评分采用患者地址计算。结果：患者主要为西班牙裔男性，肥胖，中位年龄12岁。SDI评分中位数为85（65-93）。与MASLD相比，MASH患者的中位ALT显著高于MASLD （136 vs 92 IU/L, p）。结论：在以西班牙裔为主的MASLD和高社会经济劣势儿童队列中，SDI评分较高的患者存在显著的实验室和组织学差异，表明MASLD严重程度增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.