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Dig Liver Dis. 2014 Jun;46(6):556-60. doi: 10.1016/j.dld.2014.02.010. Epub 2014 Mar 12.

Intestinal permeability is increased in children with non-alcoholic fatty liver disease, and correlates with liver disease severity.

Author information

1
Hepato-metabolic Disease Unit, Bambino Gesù Children Hospital, Rome, Italy.
2
Clinical Division of Internal Medicine, Gastroenterology and Liver Unit, Complesso Integrato Columbus Hospital, Catholic University of Rome, Italy; Institute of Internal Medicine, Catholic University of Rome, Italy.
3
Pediatric Unit, Sant'Andrea University Hospital, Rome, Italy.
4
Clinical Division of Internal Medicine, Gastroenterology and Liver Unit, Complesso Integrato Columbus Hospital, Catholic University of Rome, Italy.
5
Hepato-metabolic Disease Unit, Bambino Gesù Children Hospital, Rome, Italy. Electronic address: nobili66@yahoo.it.

Abstract

BACKGROUND:

Increased intestinal permeability seems to play a major role in non-alcoholic liver disease development and progression.

AIM:

To investigate the prevalence of altered intestinal permeability in children with non-alcoholic fatty liver disease, and to study its potential association with the stage of liver disease.

METHODS:

We performed a case-control study examining intestinal permeability in children using the lactulose-mannitol bowel permeability test.

RESULTS:

Overall, 39 consecutive patients (30 males, median age 12 years) and 21 controls (14 males, median age 11.8 years) were included. The lactulose/mannitol ratio resulted impaired in 12/39 patients (31%) and none of the controls. Intestinal permeability was higher in children with non-alcoholic fatty liver disease (lactulose/mannitol ratios: 0.038±0.037 vs. 0.008±0.007, p<0.05). Within the non-alcoholic fatty liver disease group, intestinal permeability was increased in children with steatohepatitis compared to those with steatosis only (0.05±0.04 vs. 0.03 vs. 0.03, p<0.05). Pathological lactulose/mannitol ratio correlated with portal inflammation (p=0.02), fibrosis (p=0.0002), and ballooning of hepatocytes (p=0.003). Blood lipopolysaccharides levels were higher in children with steatohepatitis (2.27±0.68 vs. 2.80±0.35, p<0.05).

CONCLUSIONS:

Intestinal permeability is increased in children with non-alcoholic fatty liver disease, and correlates with the severity of the disease.

KEYWORDS:

Intestinal permeability; Lactulose/mannitol ratio; Lipopolysaccharides; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis

PMID:
24631029
DOI:
10.1016/j.dld.2014.02.010
[Indexed for MEDLINE]

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