With nonalcoholic fatty liver disease (NAFLD), it is well-documented that adverse cardiovascular events influence mortality more than any other factor. Dyslipidemia plays an important role in these outcomes.
A recent study (KE Harlow et al. J Pediatr 2018; article in press. DOI: https://doi.org/10.1016/j.jpeds.2018.02.038) indicates that “clinically actionable dyslipidemia” is present in more than half of pediatric patients with NAFLD.
This multicenter, longitudinal cohort study included children (n=585) with NAFLD enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Nonalcoholic Steatohepatitis Clinical Research Network.
- The prevalence of children warranting intervention for low-density lipoprotein cholesterol at baseline was 14%. After 1 year of recommended dietary changes, 51% achieved goal low-density lipoprotein cholesterol, 27% qualified for enhanced dietary and lifestyle modifications, and 22% met criteria for pharmacologic intervention
- Elevated triglycerides were more prevalent, with 51% meeting criteria for intervention at baseline. At 1 year, 25% achieved goal triglycerides with diet and lifestyle changes, 38% met criteria for advanced dietary modifications, and 37% qualified for antihyperlipidemic medications.
My take: Assessing/managing dyslipidemia is an important component of NAFLD care.
Related blog posts:
- NAFLD Guidance from AASLD (2018) One of the recommendations includes the following: In patients with suspected NAFLD, the authors recommend evaluation for comorbidities including dyslipidemia, diabetes, hypothyroidism, polycystic ovary syndrome, and sleep apnea.
- Nonalcoholic Steatohepatitis Review Dyslipidemia is noted to occur in more than 70% of adults with NASH
- Pediatric NAFLD Guidelines 2017
- Concise Review: Fatty Liver in Pediatrics