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The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease

Obese and overweight children are at risk of developing nonalcoholic fatty liver disease (NAFLD), which can lead to steatohepatitis, cirrhosis, and liver transplantation. Neuropsychiatric conditions affect an increasing proportion of children and often require neuropsychiatric medications (NPMs) tha...

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Autores principales: Ryan, Jamie L., Sherman, Ashley K., Heble, Daniel E., Friesen, Craig A., Daniel, James F., Fischer, Ryan T., Slowik, Voytek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468556/
https://www.ncbi.nlm.nih.gov/pubmed/35769031
http://dx.doi.org/10.1111/cts.13358
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author Ryan, Jamie L.
Sherman, Ashley K.
Heble, Daniel E.
Friesen, Craig A.
Daniel, James F.
Fischer, Ryan T.
Slowik, Voytek
author_facet Ryan, Jamie L.
Sherman, Ashley K.
Heble, Daniel E.
Friesen, Craig A.
Daniel, James F.
Fischer, Ryan T.
Slowik, Voytek
author_sort Ryan, Jamie L.
collection PubMed
description Obese and overweight children are at risk of developing nonalcoholic fatty liver disease (NAFLD), which can lead to steatohepatitis, cirrhosis, and liver transplantation. Neuropsychiatric conditions affect an increasing proportion of children and often require neuropsychiatric medications (NPMs) that are associated with weight gain and/or drug‐induced liver injury. We sought to evaluate the role that the extended use of NPMs play in pediatric NAFLD. Medical chart review was conducted for 260 patients with NAFLD (NPM = 77, non‐NPM = 183) seen in the Liver Care Center at Children’s Mercy Hospital between 2000 and 2016. Outcome measures included body mass index (BMI) percentile, BMI z‐score, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, and gamma glutamyltransferase, and were collected at diagnosis, 6–18 month follow‐up, and 18–36 months. Controlling for race and metformin, there was a significant increase over time in BMI z‐score (p < 0.01) and total bilirubin (p = 0.03), with only initial decreases in ALT (p < 0.01) and AST (p < 0.01). Except for higher total bilirubin in the non‐NPM group, no main effect of group or interaction effect was found. Similar patterns remained when subjects were analyzed by NPM drug class. Further study is needed to confirm these findings and to evaluate the effects of NPM dose and duration of exposure, by drug class, on pediatric NAFLD outcomes.
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spelling pubmed-94685562022-09-27 The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease Ryan, Jamie L. Sherman, Ashley K. Heble, Daniel E. Friesen, Craig A. Daniel, James F. Fischer, Ryan T. Slowik, Voytek Clin Transl Sci Research Obese and overweight children are at risk of developing nonalcoholic fatty liver disease (NAFLD), which can lead to steatohepatitis, cirrhosis, and liver transplantation. Neuropsychiatric conditions affect an increasing proportion of children and often require neuropsychiatric medications (NPMs) that are associated with weight gain and/or drug‐induced liver injury. We sought to evaluate the role that the extended use of NPMs play in pediatric NAFLD. Medical chart review was conducted for 260 patients with NAFLD (NPM = 77, non‐NPM = 183) seen in the Liver Care Center at Children’s Mercy Hospital between 2000 and 2016. Outcome measures included body mass index (BMI) percentile, BMI z‐score, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, and gamma glutamyltransferase, and were collected at diagnosis, 6–18 month follow‐up, and 18–36 months. Controlling for race and metformin, there was a significant increase over time in BMI z‐score (p < 0.01) and total bilirubin (p = 0.03), with only initial decreases in ALT (p < 0.01) and AST (p < 0.01). Except for higher total bilirubin in the non‐NPM group, no main effect of group or interaction effect was found. Similar patterns remained when subjects were analyzed by NPM drug class. Further study is needed to confirm these findings and to evaluate the effects of NPM dose and duration of exposure, by drug class, on pediatric NAFLD outcomes. John Wiley and Sons Inc. 2022-07-09 2022-09 /pmc/articles/PMC9468556/ /pubmed/35769031 http://dx.doi.org/10.1111/cts.13358 Text en © 2022 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research
Ryan, Jamie L.
Sherman, Ashley K.
Heble, Daniel E.
Friesen, Craig A.
Daniel, James F.
Fischer, Ryan T.
Slowik, Voytek
The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease
title The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease
title_full The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease
title_fullStr The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease
title_full_unstemmed The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease
title_short The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease
title_sort effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9468556/
https://www.ncbi.nlm.nih.gov/pubmed/35769031
http://dx.doi.org/10.1111/cts.13358
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