The effect of neuropsychiatric medication on pediatric nonalcoholic fatty liver disease

Area of Science:

• Pediatric Gastroenterology
• Hepatology
• Child Psychiatry

Background:

• Obesity in children increases the risk of nonalcoholic fatty liver disease (NAFLD).
• Neuropsychiatric medications (NPMs) are frequently used in children and can be associated with weight gain and liver injury.
• The impact of extended NPM use on pediatric NAFLD progression requires further investigation.

Purpose of the Study:

• To evaluate the role of extended neuropsychiatric medication (NPM) use in pediatric nonalcoholic fatty liver disease (NAFLD).

Main Methods:

• Retrospective medical chart review of 260 pediatric NAFLD patients (77 NPM, 183 non-NPM) from 2000-2016.
• Collected outcome measures: BMI percentile, BMI z-score, AST, ALT, total bilirubin, GGT at diagnosis and follow-up (6-18 and 18-36 months).
• Statistical analysis controlled for race and metformin use, examining group and time effects.

Main Results:

• Over time, significant increases were observed in BMI z-score and total bilirubin (p<0.01 and p=0.03, respectively).
• Initial decreases in ALT and AST were noted (p<0.01 for both).
• No significant main effect of NPM group or interaction effect was found on most outcomes, except for higher total bilirubin in the non-NPM group.

Conclusions:

• Extended neuropsychiatric medication (NPM) use in pediatric patients with nonalcoholic fatty liver disease (NAFLD) did not demonstrate a significant negative impact on liver enzymes or BMI z-scores over the study period.
• Further research is warranted to explore the specific effects of NPM dosage, duration, and drug class on pediatric NAFLD outcomes.