SNFGE SNFGE
 
Thématique :
- Foie
Originalité :
Intermédiaire
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Docteur Jean-Louis PAYEN
Coup de coeur :
 
 
Journal of Hepatology
  2017/05  
 
  2017 May;66(5):1031-1036.  
  doi: 10.1016/j.jhep.2016.12.025.  
 
  Serum uric acid concentrations and fructose consumption are independently associated with NASH in children and adolescents.  
 
  Mosca A, Nobili V, De Vito R, Crudele A, Scorletti E, Villani A, Alisi A, Byrne CD  
  https://www.ncbi.nlm.nih.gov/pubmed/28214020  
 
 

Abstract

BACKGROUND & AIMS:

Recent research has suggested that dietary fructose intake may increase serum uric acid (UA) concentrations. Both UA concentration and fructose consumption maybe also increase in NAFLD. It is not known whether dietary fructose consumption and UA concentration are independently associated with non-alcoholic steatohepatitis (NASH). Our aim was to investigate the factors associated with NASH in children and adolescents with proven NAFLD, and to test whether UA concentrations and fructose consumption are independently associated with NASH.

METHODS:

Obese children with NAFLD were studied (n=271). NASH was diagnosed by a NAFLD activity score ⩾5 and the fatty liver inhibition of progression (FLIP) algorithm. Fructose consumption (g/day) was assessed by food frequency questionnaire, and UA (mg/dl) was measured in serum. Binary logistic regression with adjustment for covariates and potential confounders was undertaken to test factors independently associated with NASH.

RESULTS:

NASH occurred in 37.6% of patients. Hyperuricaemia (UA ⩾5.9mg/dl) was present in 47% of patients with NASH compared with 29.7% of non-NASH patients (p=0.003). Both UA concentration (OR=2.488, 95% CI: 1.87-2.83, p=0.004) and fructose consumption (OR=1.612, 95% CI 1.25-1.86, p=0.001) were independently associated with NASH, after adjustment for multiple (and all) measured confounders. Fructose consumption was independently associated with hyperuricaemia (OR=2.021, 95% CI: 1.66-2.78, p=0.01). These data were confirmed using the FLIP algorithm.

CONCLUSIONS:

Both dietary fructose consumption and serum UA concentrations are independently associated with NASH. Fructose consumption was the only factor independently associated with serum UA concentration.

LAY SUMMARY:

Currently, it is not known whether dietary fructose consumption and uric acid (UA) concentration are linked with non-alcoholic steatohepatitis (NASH) in children and adolescents. Our aim was to test whether UA concentrations and fructose consumption are independently associated with NASH in children and adolescents with proven non-alcoholic fatty liver disease (NAFLD). We show that both dietary fructose consumption and serum UA concentrations are independently associated with NASH and fructose consumption was independently linked with high serum UA concentrations.

 

  
Question posée
 
L’objectif de ce travail était d’étudier les facteurs associés à la NASH chez les enfants et adolescents, notamment vérifier si les concentrations d’acide urique et si la consommation de fructose étaient associés de façon indépendante à la NASH.
  
Question posée
 
L’uricémie et la consommation de fructose ainsi que son taux sérique sont indépendamment associées à la NASH chez l’enfant. La consommation de fructose a été le seul facteur indépendamment associé à la concentration sérique de l’acide urique.
  
Commentaires

Ces travaux permettent de mieux comprendre les facteurs liés à la NASH notamment chez les enfants et adolescents. Ils nous permettront d’affiner nos conseils diététiques dans la prise en charge de ces patients.
 
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