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Medical Forum / General / Nutrition / October 2006Fatty Liver Disease Endangers 6.5 Million U.S. Kids
http://www.forbes.com/forbeslife/health/feeds/hscout/2006/10/02/hscout535241.html Fatty Liver Disease Endangers 6.5 Million U.S. Kids 10.02.06, 12:00 AM ET MONDAY, Oct. 2 (HealthDay News) -- As many as 6.5 million American children could have a dangerous condition called non-alcoholic fatty liver disease (NAFLD), new research suggests. NAFLD -- an accumulation of fat in the liver cells -- can lead to cirrhosis of the liver, end-stage liver disease requiring a transplant, and liver cancer. Until now, there has been little research into the prevalence of NAFLD in children. For this study, researchers at the University of California, San Diego (UCSD) analyzed 742 autopsy reports and tissue samples from San Diego County children and adolescents, aged 2 to 19, who died from traumatic accidents, murder or suicide between 1993 and 2003. They found that 13 percent of the children and teens in the study had NAFLD. Based on that, they estimated that 9.6 percent of the children and adolescents in San Diego County have NAFLD. "Fatty liver disease is a very common problem that has gone largely unnoticed," study leader Jeffrey Schwimmer, an associate professor of pediatrics and director of the Fatty Liver and Weight and Wellness Clinics at Rady Children's Hospital, said in a prepared statement. "If the prevalence in the United States is similar to the prevalence in San Diego, this would translate to 6.5 million children. The scale of the problem has enormous ramifications for the future health of these children," Schwimmer said. He and his colleagues identified several major risk factors for NAFLD in children: Age -- Fatty liver was found in 0.7 percent of children aged 2-4 and in 17.3 percent of those aged 15-19. Ethnicity -- Hispanic-American children had a higher rate (11.8 percent) of fatty liver than Asians (10.2 percent), whites (8.6 percent) or blacks (1.5 percent). Gender -- Boys had a much higher rate of fatty liver than girls. Obesity -- Overweight and obese children accounted for 81 percent of all cases of fatty liver in the study. *********** Pate de Fois Gras is made by force feeding ducks and geese large amounts of grains (ie. carbs). Could it be that the massive load of grains in the SAD diet is causing fatty livers in children? Hmmmm. Quite the societal-nutritional experiment we've got going here in the US. TC > http://www.forbes.com/forbeslife/health/feeds/hscout/2006/10/02/hscout535241.html > [quoted text clipped - 50 lines] > experiment we've got going here in the US. > TC >>Could it be that the massive load of grains in the SAD diet is causing fatty livers in children? Hmmmm. Quite the societal-nutritional experiment we've got going here in the US. TC<< Only if you showed the same .. rate .. in vegetarian children. They have shown a direct correlation between increased iron levels and NAFLD .. so much so .. that they have begun a .. study .. http://www.clinicaltrials.gov/show/NCT00230087 Iron Depletion Therapy for Type 2 DM and NAFLD This study is currently recruiting patients. Verified by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) March 2006 Sponsored by: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Information provided by: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) ClinicalTrials.gov Identifier: NCT00230087 Purpose The purpose of this study is to find out whether lowering the amount of iron in the body will result in less resistance to insulin and improved liver function in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease. This may result in better diabetes control and/or a decrease in the amount of liver fat. Condition Intervention Phase Non-Alcoholic Fatty Liver Disease Diabetes Mellitus Procedure: iron depletion by phlebotomy Phase II MedlinePlus related topics: Diabetes Study Type: Interventional Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study Official Title: Iron Depletion Therapy for Patients With Type 2 Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease Further study details as provided by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): Primary Outcomes: · Improved insulin sensitivity as determined by:; (1) hyperinsulinemic euglycemic clamp method; (2) HOMA model- determined by the OGTT method Secondary Outcomes: · Change in serum aminotransferase levels; · Change in levels of serum, plasma and urinary markers of oxidative stress; · Changes in intrahepatic and intraabdominal fat content as determined by CT scan; · Change in serum levels of proinflammatory cytokines (ie IL-6, TnF-aR2) Expected Total Enrollment: 15 Study start: September 2005; Expected completion: January 2008 Last follow-up: October 2007; Data entry closure: December 2007 Nonalcoholic fatty liver disease (NAFLD) is a common liver disease in the United States. NAFLD can lead to severe liver disease in some patients. Patients with NAFLD develop resistance to the normal action of insulin. Insulin is important for processing sugar and fat and increased resistance to insulin leads to fat in the liver. There is a correlation between the amount of iron in a person's body and the ability of insulin to work properly. Several small studies suggest that removal of iron may improve both diabetes and NAFLD by lowering insulin resistance. The goal of this pilot study is to determine the effect of iron depletion on insulin sensitivity in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease. This study will be performed as an ancillary P&F study to the NASH CRN; all participants will be recruited from the NASH CRN Database Study. Secondary outcome measures will include the effect of iron depletion on hepatic necroinflammation, markers of oxidative stress and intrahepatic fat content. Insulin resistance will be directly measured using a two-step hyperinsulinemic euglycemic clamp procedure, before and after iron depletion by phlebotomy. Oral glucose tolerance tests will also be performed in order to evaluate the efficacy of using the indirect, but less cumbersome, HOMA model to derive values of insulin resistance in this patient cohort. This study will advance our understanding of the role of body iron stores in the pathophysiology of type 2 diabetes mellitus and non-alcoholic fatty liver disease. If iron depletion results in improved insulin sensitivity, reduced hepatic necroinflammation and/or intrahepatic fat content, a large scale, randomized, controlled trial of iron depletion in patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease will be planned. Eligibility Ages Eligible for Study: 18 Years - 65 Years, Genders Eligible for Study: Both Criteria Inclusion Criteria Histological evidence of NAFLD and enrollment in NASH CRN Database Study Type 2 DM treated with diet or a stable dose of non-insulin sensitizing oral hypoglycemic agents for > 3 mo. Hemoglobin HbA1c level = 8 % Serum ALT levels =1.3 x ULN Between 18-65 years of age Exclusion Criteria Hereditary hemochromatosis or hepatic iron overload defined as any of the following: 2+ iron on hepatic iron staining Hepatic Iron Index = 1.9 C282Y homozygous or C282Y/H63D compound heterozygous HFE genotype Use of insulin or thiazolidinediones for the treatment of diabetes Use of anti-NASH drugs (thiazolidinediones, vitamin E, UDCA, SAM-e, betaine, milk thistle, gemfibrozil, anti-TNF therapies, probiotics) Serum ferritin <50µg/L Serum transferrin-iron saturation <10 % Hemoglobin <10 mg/L Hematocrit <38 % Voluntary blood donation or therapeutic phlebotomy within the previous twelve months (except routine lab tests) Pregnant or lactating women Prior history of coronary artery disease, myocardial infarction, exertional dyspnea or chronic chest pain at rest. Evidence of myocardial infarction as determined by an ECG Location and Contact Information Please refer to this study by ClinicalTrials.gov identifier NCT00230087 Jim E Nelson, PhD 206-221-4537 jam...@medicine.washington.edu Virginia Mugford, BS 206-221-4538 virgin...@medicine.washington.edu Washington University of Washington Medical Center, Seattle, Washington, 98195, United States; Recruiting Jim Nelson, PhD 206-221-4537 jam...@medicine.washington.edu Study chairs or principal investigators Kris V Kowdley, MD, Principal Investigator, University of Washington More Information Study ID Numbers: DK 61728-S1 Last Updated: March 6, 2006 Record first received: September 29, 2005 ClinicalTrials.gov Identifier: NCT00230087 Health Authority: United States: Federal Government ClinicalTrials.gov processed this record on 2006-06-28 U.S. National Library of Medicine, Contact NLM Customer Service National Institutes of Health, Department of Health & Human Services Copyright, Privacy, Accessibility, Freedom of Information Act Who loves ya. Tom Jesus Was A Vegetarian! http://jesuswasavegetarian.7h.com Man Is A Herbivore! http://tinyurl.com/a3cc3 DEAD PEOPLE WALKING http://tinyurl.com/zk9fk > > http://www.forbes.com/forbeslife/health/feeds/hscout/2006/10/02/hscout535241.html > > [quoted text clipped - 55 lines] > experiment we've got going here in the US. > TC<< > Only if you showed the same .. rate .. in vegetarian children. Do you have anything that shows otherwise? How do you know that that numbers do not include vegetarian children? TC > They have shown a direct correlation between increased iron levels and > NAFLD .. so much so .. that they have begun a .. study .. [quoted text clipped - 163 lines] > DEAD PEOPLE WALKING > http://tinyurl.com/zk9fk |
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