Journal of Pediatric Gastroenterology and Nutrition最新文献

{"title":"Growth hormone resistance in children with chronic cholestatic liver disease and reduced skeletal muscle mass.","authors":"Julia M Boster, Kelly Gilmartin, Zhaoxing Pan, Ronald J Sokol, Shikha S Sundaram","doi":"10.1002/jpn3.70210","DOIUrl":"https://doi.org/10.1002/jpn3.70210","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate potential mechanisms of muscle wasting in children with chronic cholestatic liver disease (CCLD).</p><p><strong>Methods: </strong>This is a cross-sectional study comparing estimated skeletal muscle mass (eSMM) z-score, assessed by whole body dual energy X-ray absorptiometry (DXA), in children with CCLD versus healthy controls. Relationships between eSMM z-score and serum growth hormone (GH), insulin-like growth factor 1 (IGF-1), myostatin, and ammonia were analyzed by Spearman correlation and multiple linear regression. Myopenia was defined as eSMM z-score ≤ -2.</p><p><strong>Results: </strong>DXA was obtained in 15 children with CCLD (eight biliary atresia, four Alagille syndrome, one alpha-1-antitrypsin deficiency, one bile salt export protein deficiency, one idiopathic cirrhosis; mean age 12.1 ± 3.9 years) and 19 controls (mean age 11.5 ± 3.9 years). Although growth and muscle mass (eSMM z-score) were similar between CCLD and controls, children with CCLD had significantly higher GH levels (2.7 ± 4.0 ng/mL vs. 0.5 ± 0.6 ng/mL, p = 0.04) and lower IGF-1 z-score (-0.9 ± 0.8 vs. 0.0 ± 0.5, p < 0.01), indicating GH resistance in CCLD. Children with CCLD and myopenia had significantly higher GH levels than those without myopenia (median 7.9 [0.5-13.0] ng/mL vs. 0.3 [0.0-4.6] ng/mL, p = 0.04), with a trend toward a moderate inverse correlation between GH and eSMM z-score in CCLD (rho = -0.48, p = 0.07).</p><p><strong>Conclusions: </strong>GH resistance is prevalent in CCLD, even in older children with relatively mild liver disease severity and preserved growth. The relationship between eSMM z-score and GH indicates a potential role for GH resistance in the development of myopenia in CCLD.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional gastrointestinal disorders are highly prevalent in children with short stature and linked to reduced growth velocity.","authors":"Xi Bai, Xiaoyuan Guo, Zhibo Zhou, Shanshan Liu, Yiling He, Hongbo Yang, Huijuan Zhu, Hui Pan, Xiaoqing Li","doi":"10.1002/jpn3.70203","DOIUrl":"https://doi.org/10.1002/jpn3.70203","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the prevalence of functional gastrointestinal disorders (FGIDs) in children with short stature and their association with growth status.</p><p><strong>Methods: </strong>Confirmed children with short stature without treatment were consecutively enrolled in a tertiary hospital from November 1 2020 to June 30 2021, and from March 1 2023 to April 30 2023. All participants completed an FGIDs questionnaire based on the Rome IV pediatric diagnostic criteria. Anthropometrics, demographic, and laboratory data were collected. The participants were divided into two groups according to whether FGIDs were combined, and the differences between the two groups were analyzed.</p><p><strong>Results: </strong>One hundred three children with short stature were included, and the overall prevalence of FGIDs was 48.5% (n = 50). The prevalence of functional dyspepsia (FD), functional constipation (FC), and irritable bowel syndrome was 31.1%, 21.4%, and 1.0%, respectively. Children with FGIDs showed significantly lower growth velocity in comparison to those without FGIDs (p = 0.001). Multivariable linear regression analysis showed an independent association between FGIDs and growth velocity (β = -0.97, p = 0.020).</p><p><strong>Conclusion: </strong>Children with short stature had a high prevalence of FGIDs. The children with FGIDs, especially FD and FC, presented significantly lower growth velocity. Impact of FGIDs on growth velocity should be considered in children with short stature.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Saccharomyces cerevisiae antibodies positivity is not linked to antitumor necrosis factor-α durability in pediatric Crohn's disease patients: A single-center study.","authors":"Daniel Ling, Rinat Grabovski, Manar Matar, Dror S Shouval, Yael Weintraub","doi":"10.1002/jpn3.70209","DOIUrl":"https://doi.org/10.1002/jpn3.70209","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crohn's disease exclusion diet as an add-on to antitumor necrosis factor-α therapy in children with moderate-to-severe Crohn's disease.","authors":"Saverio Pochesci, Luca Scarallo, Tiziana Miraglia, Paolo Lionetti","doi":"10.1002/jpn3.70208","DOIUrl":"https://doi.org/10.1002/jpn3.70208","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunological effects of alpha-lactalbumin-enriched low-protein infant formula: A randomized controlled trial.","authors":"Ulrika T Nilsson, Olle Hernell, Bo Lönnerdal, Lotte N Jacobsen, Maria Nunez-Salces, Anne S Kvistgaard, Christina West, Pia K Åkeson","doi":"10.1002/jpn3.70189","DOIUrl":"https://doi.org/10.1002/jpn3.70189","url":null,"abstract":"<p><strong>Objectives: </strong>Breast-fed (BF) have lower risk of infections during infancy compared to those formula-fed (FF). A higher content of alpha-lactalbumin (α-lac) in breast milk, which may promote a more favorable gut microbiota, could be one reason. In this study, we evaluated whether increased concentration of α-lac in low-protein infant formula affects the immune response and the incidence of infections during infancy.</p><p><strong>Methods: </strong>In a double-blinded randomized controlled trial, healthy-term infants (n = 245) received low-protein infant formulas with α-lac-enriched whey (α-lac-EW; 1.75 g protein/100 kcal, 27% α-lac) or casein glycomacropeptide-reduced whey (CGMP-RW; 1.76 g protein/100 kcal, 14% α-lac), or standard formula (SF; 2.2 g protein/100 kcal, 10% α-lac) from 2 to 6 months. BF constituted a reference group. Cytokines and high-sensitivity C-reactive protein (hsCRP) were measured during intervention and infection-related morbidity, and treatment was evaluated until 12 months.</p><p><strong>Results: </strong>Serum interleukin-6 (IL-6) was lower in BF than in all FF groups during intervention (p < 0.001). No other differences in cytokines (tumor necrosis factor alpha [TNF-α], transforming growth factor beta 1 [TGF-β1], TGF-β2, IL-1, IL-10, IL-12, interferon gamma [INF-γ]) or hsCRP were found among the study groups. Infection-related morbidity did not differ among study groups, except slight differences in the use of antibiotics during (α-lac-EW vs. CGMP-RW [p = 0.008]) and after intervention (α-lac-EW vs. BF [p = 0.016]).</p><p><strong>Conclusions: </strong>Increased α-lac concentration in low-protein infant formula to levels similar to breast milk did not affect the cytokine profile and had minor effect on infection-related morbidity. The higher IL-6 concentrations in FF than in BF needs further investigation.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term gastrointestinal outcomes in pediatric intestinal malrotation patients following operative treatment.","authors":"Katie E Corcoran, Sydney A Martinez, Savas Tsikis, Mohammad A Al-Mamun","doi":"10.1002/jpn3.70204","DOIUrl":"10.1002/jpn3.70204","url":null,"abstract":"","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of paediatric ulcerative colitis, part 2: Acute severe colitis-An updated evidence-based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organization.","authors":"Amit Assa, Marina Aloi, Stephanie Van Biervliet, Jiri Bronsky, Javier M di Carpi, Marco Gasparetto, Laura Gianolio, Hannah Gordon, Iva Hojsak, Alexandra S Hudson, Séamus Hussey, Johan Van Limbergen, Erasmo Miele, Lorenzo Norsa, Ola Olén, Gianluca Pellino, Patrick van Rheenen, Lissy de Ridder, Richard K Russell, Dror S Shouval, Eunice Trindade, Turner Dan, David C Wilson, Anat Yerushalmy-Feler, Eytan Wine","doi":"10.1002/jpn3.70096","DOIUrl":"10.1002/jpn3.70096","url":null,"abstract":"<p><p>Acute severe colitis (ASC) is a relatively frequent manifestation in children with ulcerative colitis and one of the few emergencies in paediatric gastroenterology. A standardized proactive approach based on tight monitoring and timely medical and surgical interventions may improve patients' outcomes. We aimed to update the previous ASC guidelines using detailed recommendations and practice points, based on a systematic review of the literature and consensus of experts. These guidelines update is a joint effort of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organization. A systematic search was performed in Pubmed Ovid Medline, Embase and Cochrane databases using 13 predefined PICO (patient, intervention, comparison, outcomes) based questions and 30 non-PICO based questions. Grading methodology was based on the Oxford Centre for Evidence-Based Medicine-Levels of evidence. The questions were addressed by working subgroups following an iterative consensus voting process, including three online voting meetings and one face-to-face meeting. A total of 36 recommendations and 72 practice points were endorsed with a consensus rate of at least 88% for all statements, regarding initial evaluation, monitoring, medical and surgical treatment of ASC in children. Several topics have been revised since the previous 2018 guidelines and differ from corresponding published adult guidelines. These guidelines present a comprehensive overview of the management of ASC in children, offering practical recommendations and practice points aiming to standardize clinical and surgical treatment and improve outcomes of this severe scenario.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"816-851"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis: Histological severity of biopsy-proven metabolic dysfunction-associated steatotic liver disease in pediatric patients.","authors":"Matheus Souza, Samira Mohamad Khalil, Fabiana Dolovitsch de Oliveira","doi":"10.1002/jpn3.70157","DOIUrl":"10.1002/jpn3.70157","url":null,"abstract":"<p><p>The burden of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing in children and adolescents. However, the severity of disease at diagnosis by liver biopsy remains uncertain and has not been systematically evaluated. We conducted a systematic review and meta-analysis to determine the prevalence of metabolic dysfunction-associated steatohepatitis (MASH), significant and advanced fibrosis in this population. PubMed and Embase databases were systematically searched (from inception to September 17, 2024) for studies reporting liver histology in pediatric patients (≤21 years) with biopsy-proven MASLD. Meta-analysis of proportions was performed using a generalized linear mixed model with Clopper-Pearson intervals to obtain pooled prevalence estimates. Of 4761 records identified, we included 35 studies with 5898 pediatric patients with biopsy-proven MASLD (33.4% girls; mean age 12.6 years). The pooled prevalences of MASH, significant fibrosis (defined as ≥F2) and advanced fibrosis (defined as ≥F3) based on histology were 59.95% (n = 18 studies, 95% confidence interval [CI]: 46.89-71.73, I² = 97%), 30.53% (n = 26 studies, 95% CI: 22.32-40.20, I² = 94%), and 11.77% (n = 28 studies, 95% CI: 8.10-16.80, I² = 89%), respectively. Subgroup analyses showed higher prevalence of advanced fibrosis in studies with <100 patients compared to larger studies. Meta-regressions did not show an influence of age, sex, and body mass index on the prevalences. Sensitivity analyses did not modify these results. Pediatric patients have considerable severity of MASLD at diagnosis by liver biopsy. Developing effective screening and risk stratification strategies for this group is urgently needed.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"663-673"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcium butyrate efficacy in pediatric irritable bowel syndrome: Randomized placebo-controlled multiomics-based clinical trial.","authors":"Fernanda Cristofori, Francesco Maria Calabrese, Ilaria Iacobellis, Monica Santamaria, Giuseppe Celano, Ilario Ferrocino, Emanuela Di Sabato, Rocco Pergola, Vanessa N Dargenio, Leonardo Paulucci, Maria De Angelis, Ruggiero Francavilla","doi":"10.1002/jpn3.70154","DOIUrl":"10.1002/jpn3.70154","url":null,"abstract":"<p><strong>Objective: </strong>Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders, and treatment involves nonpharmacological and pharmacological therapies, even if there is no optimal therapy. This randomized, placebo-controlled, double-blind trial aimed to evaluate the efficacy of calcium butyrate supplementation in reducing IBS symptoms and to assess its effects on gut microbiota composition and relative metabolic profiles through a multiomics approach.</p><p><strong>Methods: </strong>Children aged 4-17 years with IBS diagnosed according to the Rome IV criteria were randomized to receive either a formulation based on calcium butyrate (500 mg/day) or placebo for 8 weeks, followed by a 4-week follow-up period. Clinical assessments included the visual analogue scale (VAS) and gastrointestinal symptom rating scale (GSRS). Fecal samples were analyzed via 16S metataxonomics and targeted/untargeted metabolomics. The primary outcome was an ≥50% reduction in the VAS scores. Secondary outcomes included microbiota composition changes and metabolite profile alterations.</p><p><strong>Results: </strong>Fifty-one children were enrolled. Treatment success was significantly higher in the butyrate group (73% vs. 3.8%, p < 0.0001). VAS and GSRS scores were significantly reduced in butyrate-treated patients at the end of treatment and postwashout. Metataxonomic analysis revealed increased short chain fatty acids-producing bacteria, including Lachnospiraceae and Ruminococcus gauvreauii, while pro-inflammatory taxa such as Ruminococcus gnavus decreased. Metabolomics confirmed significant changes in SCFA and VOCs, supporting microbiota modulation.</p><p><strong>Discussion: </strong>Calcium butyrate supplementation effectively reduced IBS symptoms and induced beneficial microbiota and metabolic shifts in pediatric patients. These findings support butyrate as a potential therapy in pediatric IBS, warranting further large-scale investigations to confirm efficacy and optimize dosing strategies.</p><p><strong>Clinical trial identification number: </strong>Study registered on: https://ClinicalTrials.gov. Number of registration: NCT04566679 Date of registration: 28/09/2020. Date of first enrollment of patients: 01/05/2021.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"551-561"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12408980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based review of the nutritional treatment of obesity and metabolic dysfunction-associated steatotic liver disease in children and adolescents.","authors":"Sara Karjoo, Amy Braglia-Tarpey, Alvin P Chan, Ana Gabriela Ayala Germán, Rachel E Herdes, Nikhil Pai, Desiree Sierra-Velez, Bridget Whitehead, Ruben E Quiros-Tejeira, Debora Duro","doi":"10.1002/jpn3.70099","DOIUrl":"10.1002/jpn3.70099","url":null,"abstract":"<p><p>The growing pediatric obesity epidemic has paralleled the surge in metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis. It develops due to nutritional imbalances, microbiome dysbiosis, gene regulation, hormonal changes, and environmental factors like food deserts, low activity level, and an unhealthy lifestyle. The prevalence of MASLD and obesity is rising every year. Lifestyle changes remain the mainstay treatment for obesity and MASLD. Per the 2023 American Association for the Study of Liver Diseases Practice Guidance on MASLD, achieving ≥5% weight loss can reduce hepatic steatosis, ≥7% weight loss can reduce hepatic inflammation, and ≥10% weight loss can reduce liver fibrosis. Therefore, nutritional interventions can be a powerful tool to help correct metabolic dysfunction and promote healthy weight loss. Current endorsed nutritional interventions for weight loss or MASLD include the Mediterranean diet, low glycemic/low carbohydrate diet, plant-based diet/anti-inflammatory diet, ketogenic diet, and intermittent fasting. This review provides evidence-based insights into current nutritional interventions for children and adolescents with obesity and MASLD to help guide pediatric gastroenterologists in making the best dietary-based recommendations in clinical practice.</p>","PeriodicalId":16694,"journal":{"name":"Journal of Pediatric Gastroenterology and Nutrition","volume":" ","pages":"485-496"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}