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A Mouse Model of Chronic Liver Fibrosis for the Study of Biliary Atresia
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Serum bilirubin level is inversely associated with nonalcoholic steatohepatitis in children

Kanika Puri1, Valerio Nobili, Katherine Melville

  • 1Department of Pediatrics, SUNY Downstate, Brooklyn, NY, USA.

Journal of Pediatric Gastroenterology and Nutrition
|March 23, 2013
PubMed

Insights

In children with nonalcoholic fatty liver disease (NAFLD), lower serum bilirubin levels correlate with nonalcoholic steatohepatitis (NASH). Higher bilirubin may protect against NASH development due to its antioxidant properties.

Area of Science:

  • Pediatric Gastroenterology and Hepatology
  • Oxidative Stress and Antioxidants
  • Liver Disease Pathophysiology

Background:

  • Nonalcoholic fatty liver disease (NAFLD) is a growing concern in children.
  • Oxidative stress is a key factor in NAFLD progression to nonalcoholic steatohepatitis (NASH).
  • Bilirubin, an endogenous antioxidant, may play a protective role.

Purpose of the Study:

  • To investigate the association between serum bilirubin levels and liver histology in pediatric NAFLD patients.
  • To determine if bilirubin levels correlate with NASH or fibrosis in children with NAFLD.

Main Methods:

  • Retrospective analysis of 302 children with biopsy-proven NAFLD.
  • Collection of demographic, clinical, and histopathological data.
  • Logistic regression used to identify factors associated with NASH and fibrosis.

Main Results:

  • NASH was present in 67% and fibrosis in 64.2% of pediatric patients.
  • Mean total bilirubin was significantly lower in the NASH group (0.65 ± 0.24 mg/dL) vs. non-NASH (0.73 ± 0.22 mg/dL).
  • Higher bilirubin levels showed an inverse correlation with steatosis, NAFLD activity score, and a trend for fibrosis/inflammation, and were associated with decreased odds of NASH.

Conclusions:

  • Serum bilirubin levels are inversely related to the presence of NASH in children with NAFLD.
  • The antioxidant properties of bilirubin may contribute to its protective effect against NASH development.
Abstract

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