Study: Fructose Consumption Is Associated with Nonalcoholic Steatohepatitis in Children

Fructose, consumed primarily in sodas and other sweetened beverages, and serum uric acid concentrations are independently associated with nonalcoholic steatohepatitis (NASH) in adolescents and children, according to a new study.

Past studies have suggested that dietary fructose consumption might increase serum uric acid concentrations, and uric acid concentrations and fructose consumption may be increased in patients with nonalcoholic fatty liver disease (NAFLD). However, it is not known if fructose consumption and serum uric concentrations are independently associated with NASH.
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The study included 271 obese children with NAFLD who were diagnosed with NASH based upon the fatty liver inhibition of progression algorithm (FLIP) and whether they had an NAFLD activity score greater than or equal to 5. The mean age was 12.5 years, and 155 of the 271 children were male.

Food frequency questionnaires were used to assess fructose consumption, and uric acid concentration was measured in serum. Researchers used binary logistic regression with adjustment for covariates and potential confounders to test for factors independently associated with NASH.

Overall, 37.6% of the patients were diagnosed with NASH, and 47% of patients with NASH had hyperuricemia compared to 29.7% of patients without NASH.

Researchers found that both uric acid concentrations and fructose consumption were independently associated with NASH after adjusting for multiple confounders. In addition, fructose consumption was independently associated with hyperuricemia.

“In this study, we show for the first time that uric acid concentrations and dietary fructose consumption are independently and positively associated with NASH. The development of NASH may markedly affect life expectancy and quality of life in affected individuals and therefore it is crucial to understand the risk factors for NASH in children and adolescents in order to design effective interventions which can be used safely to treat this young group of patients,” concluded senior investigator Dr Valerio Nobili, chief of the Hepatometabolic Unit Liver Diseases Laboratory at Bambino Gesù Hospital in Rome, Italy.

—Melissa Weiss

Reference:

1) Mosca A, Nobili V, De Vito R, et al. Serum uric acid concentrations and fructose consumption are independently associated with NASH in children adolescents [published online February 14, 2017]. J Hepatol. doi:http://dx.doi.org/10.1016/j.jhep.2016.12.025.

2) Fructose consumption linked to the increase of liver disease among adolescents and children [press release]. Amsterdam, Netherlands: J Hepatol; February 14, 2017. http://www.journal-of-hepatology.eu/pb/assets/raw/Health%20Advance/journals/jhepat/JHEPATMay17PRMosca.pdf