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The potential role of fatty liver in paediatric metabolic syndrome: a distinct phenotype with high metabolic risk?

Authors

  • V. Nobili,

    Corresponding author
    • Metabolic and Autoimmune Liver Disease Unit, Bambino Gesù Children's Hospital, Rome, Italy
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    • Italian Hobbit Network on Pediatric Nutrition.
  • G. Bedogni,

    1. Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy
    2. Institute of Pediatrics, Milan University Medical School, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
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    • Italian Hobbit Network on Pediatric Nutrition.
  • R. Berni Canani,

    1. Department of Pediatrics and European Laboratory for the Investigation of Food Induced Diseases (ELFID), University of Naples ‘Federico II’, Naples, Italy
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    • Italian Hobbit Network on Pediatric Nutrition.
  • P. Brambilla,

    1. Azienda Sanitaria Locale Milano 2, Milano, Italy
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    • Italian Hobbit Network on Pediatric Nutrition.
  • S. Cianfarani,

    1. Molecular Endocrinology Unit-DPUO, Bambino Gesù Children's Hospital, Rome, Italy
    2. Department of Systems Medicine, Tor Vergata University Medical School, Rome, Italy
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    • Italian Hobbit Network on Pediatric Nutrition.
  • A. Pietrobelli,

    1. Pediatric Unit, Verona University Medical School, Verona, Italy
    2. Pennington Biomedical Research Center, Baton Rouge, LA, USA
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    • Italian Hobbit Network on Pediatric Nutrition.
  • C. Agostoni

    1. Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy
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    • Italian Hobbit Network on Pediatric Nutrition.

  • Statement of financial support: Any financial assistance was received in support of this study.

Address for correspondence: Dr V Nobili, Metabolic and Autoimmune Liver Disease Unit, Bambino Gesù Children's Hospital, Piazza S. Onofrio 4, 00165 Rome, Italy. E-mail: nobili66@yahoo.it

Summary

Background

The prevalence of obesity and its metabolic consequences has dramatically increased in the last two decades urging physicians to find a reliable definition for early detection, treatment and possibly prevention of metabolic syndrome (MS). MS could be diagnosed in adult patients in the presence of a large waist circumference and ≥2 of the following features: high serum triglycerides, low serum high-density lipoprotein cholesterol, high blood pressure and high fasting glucose. The definition of MS in children is more problematic, and the potential role of its single components on metabolic risk remains largely undefined. Recent evidence strongly suggests not only a relationship between non-alcoholic fatty liver disease (NAFLD) and MS in obese children, adolescents and adults, but also the key role exerted by liver fat deposition in the pathogenesis of MS.

Conclusion

We propose that NAFLD should be routinely checked in obese subjects because early lifestyle changes may be effective in reducing the overall risk of MS.

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