Effect of N-acetyl cysteine in children with metabolic dysfunction-associated steatotic liver disease-A pilot study

Effect of N-acetyl cysteine in children with metabolic dysfunction-associated steatotic liver disease-A pilot study

Prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), and its sequelae of more severe forms such as metabolic dysfunction-associated steatohepatitis (MASH) is rapidly increasing in children with the rise in obesi...

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Veröffentlicht in:Journal of pediatric gastroenterology and nutrition 2024-09, Vol.79 (3), p.652-660
Hauptverfasser: Babu Balagopal, P, Kohli, Rohit, Uppal, Vikas, Averill, Lauren, Shah, Chetan, McGoogan, Katherine, Di Guglielmo, Matthew, Goran, Michael, Hossain, Md Jobayer
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container_issue 3
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container_title Journal of pediatric gastroenterology and nutrition
container_volume 79
creator Babu Balagopal, P
Kohli, Rohit
Uppal, Vikas
Averill, Lauren
Shah, Chetan
McGoogan, Katherine
Di Guglielmo, Matthew
Goran, Michael
Hossain, Md Jobayer
description Prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), and its sequelae of more severe forms such as metabolic dysfunction-associated steatohepatitis (MASH) is rapidly increasing in children with the rise in obesity. Successful and sustainable treatments for MASLD are lacking in children. We determined the therapeutic effect of N-acetyl cysteine (NAC) on biomarkers of oxidative stress, inflammation and insulin resistance (IR), liver enzymes, liver fat fraction (LFF) and (LS) in children with obesity and biopsy-confirmed MASLD. Thirteen children (n = 13; age: 13.6 ± 2.8 years; NAS score >2) underwent a double-blind, placebo-controlled trial of NAC (either 600 or 1200 mg NAC/day) or placebo for 16 weeks. Measurements included LFF (magnetic resonance imaging), LS (ultrasound elastography), and body composition. Erythrocyte glutathione (GSH), liver enzymes, insulin, glucose, adiponectin, high-sensitivity c-reactive protein (hs-CRP), and interleukin-6 (IL-6) were also measured. HOMA-IR was calculated. Sixteen-week NAC treatment improved (baseline adjusted between-group p 
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Successful and sustainable treatments for MASLD are lacking in children. We determined the therapeutic effect of N-acetyl cysteine (NAC) on biomarkers of oxidative stress, inflammation and insulin resistance (IR), liver enzymes, liver fat fraction (LFF) and (LS) in children with obesity and biopsy-confirmed MASLD. Thirteen children (n = 13; age: 13.6 ± 2.8 years; NAS score &gt;2) underwent a double-blind, placebo-controlled trial of NAC (either 600 or 1200 mg NAC/day) or placebo for 16 weeks. Measurements included LFF (magnetic resonance imaging), LS (ultrasound elastography), and body composition. Erythrocyte glutathione (GSH), liver enzymes, insulin, glucose, adiponectin, high-sensitivity c-reactive protein (hs-CRP), and interleukin-6 (IL-6) were also measured. HOMA-IR was calculated. Sixteen-week NAC treatment improved (baseline adjusted between-group p &lt; .05 for all) markers of inflammation (IL-6 and hs-CRP), oxidative stress (GSH), and insulin resistance (HOMA-IR) and reduced liver enzymes, LFF and LS. Body weight and body composition did not show beneficial changes. Sixteen-week NAC treatment was well tolerated in children with obesity and MASLD and led to improvements in oxidative stress, inflammation and IR and liver outcomes. 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title Effect of N-acetyl cysteine in children with metabolic dysfunction-associated steatotic liver disease-A pilot study
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