Abstract
Background
Increased intestinal permeability seems to play a major role in non-alcoholic liver
disease development and progression.
Aim
To investigate the prevalence of altered intestinal permeability in children with
non-alcoholic fatty liver disease, and to study its potential association with the
stage of liver disease.
Methods
We performed a case–control study examining intestinal permeability in children using
the lactulose–mannitol bowel permeability test.
Results
Overall, 39 consecutive patients (30 males, median age 12 years) and 21 controls (14
males, median age 11.8 years) were included. The lactulose/mannitol ratio resulted
impaired in 12/39 patients (31%) and none of the controls. Intestinal permeability
was higher in children with non-alcoholic fatty liver disease (lactulose/mannitol
ratios: 0.038 ± 0.037 vs. 0.008 ± 0.007, p < 0.05). Within the non-alcoholic fatty liver disease group, intestinal permeability
was increased in children with steatohepatitis compared to those with steatosis only
(0.05 ± 0.04 vs. 0.03 vs. 0.03, p < 0.05). Pathological lactulose/mannitol ratio correlated with portal inflammation (p = 0.02), fibrosis (p = 0.0002), and ballooning of hepatocytes (p = 0.003). Blood lipopolysaccharides levels were higher in children with steatohepatitis
(2.27 ± 0.68 vs. 2.80 ± 0.35, p < 0.05).
Conclusions
Intestinal permeability is increased in children with non-alcoholic fatty liver disease,
and correlates with the severity of the disease.
Keywords
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Article info
Publication history
Published online: March 14, 2014
Accepted:
February 12,
2014
Received:
December 8,
2013
Identification
Copyright
© 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc. All rights reserved.
