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©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Dec 15, 2014; 5(6): 917-923
Published online Dec 15, 2014. doi: 10.4239/wjd.v5.i6.917
Published online Dec 15, 2014. doi: 10.4239/wjd.v5.i6.917
Nonalcoholic steatohepatitis and insulin resistance in children
Mikage Arata, Junya Nakajima, Shigeo Nishimata, Tomomi Nagata, Hisashi Kawashima, Department of Pediatrics, Tokyo Medical University, Tokyo 160-0023, Japan
Author contributions: Arata M and Kawashima H conceived and wrote the manuscript, and contributed equally to this manuscript; Nakajima J, Nishimata S and Nagata T investigated the studies on cytokines and pathological studies, and assisted in designing the figures and tables.
Correspondence to: Hisashi Kawashima, MD, PhD, Department of Pediatrics, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. hisashi@tokyo-med.ac.jp
Telephone: +81-03-33426111 Fax: +81-03-33440643
Received: August 20, 2014
Revised: October 7, 2014
Accepted: November 7, 2014
Published online: December 15, 2014
Processing time: 114 Days and 21.3 Hours
Revised: October 7, 2014
Accepted: November 7, 2014
Published online: December 15, 2014
Processing time: 114 Days and 21.3 Hours
Core Tip
Core tip: The pathological characteristics of nonalcoholic steatohepatitis (NASH) are significantly different between children and adults. Nonalcoholic fatty liver disease is accompanied by insulin resistance, which plays a pivotal role in its pathophysiology in both adults and children. In NASH, a “two-hit” model involving triglyceride accumulation (first hit) and liver damage (second hit) has been accepted. Insulin resistance was found to correlate with changes in fat levels; however, it did not correlate with fibrosis in children. Insulin resistance may be important in the first hit. Genetic predisposition as well as environmental factors might be the second hit in children.