Ursodeoxycholic acid benefi t in pediatric non-alcoholic fatty liver disease

Introduction. Nonalcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease in children, encompasses a range of disease from simple steatosis to steatohepatitis (NASH). Ursodeoxycholic acid (UDCA) has been used in adult pacients with NASH, demonstrating its effi cacy in high doses. Purpose. The aim of our study was to assess the effect of high-dose ursodeoxycholic acid therapy on liver functions in children with NASH. Methods. We prospectively studied 18 children with NASH aged 2.5 to 17 years. NASH was operationally defi ned as diffusely hyperechogenic liver at ultrasonography with persistently elevated (> 35 UI/l) alanine aminotransferase (ALT) or aspartate aminotransferaze (AST) after exclusion of viral, alcohol-induced, druginduced, cholestatic and genetic causes of liver disease. Patients were treated with ursodeoxycolic acid (20 mg/ kg per day) for six month. Results. Treatment with UDCA signifi cantly decreased hepatic transaminases. ALT levels ranged from 68.5 (50-166) at baseline vs. 47 (29-104) after six month, p <0.001, AST from 43 (29-101) 34 (17-75), p < 0.001, and GGT between 41.5 (11-150) vs. 22 (8-55). At the end of treatment, ALT levels normalized in 4 patients. Moreover, cholesterol levels were signifi cantly reduced after treatment. Conclusions. Treatment with high-dose ursodeoxycholic acid improves liver function parameters in children with NASH.