Nonalcoholic steatohepatitis and insulin resistance in children

Table 2 Reports in the literature regarding insulin resistance in pediatric nonalcoholic steatohepatitis /nonalcoholic fatty liver disease

Ref.	Study population and sample size	Age (yr)	Method of diagnosis	Insulin resistance
Santoro et al[32]	229 obese children, including 12 cases of liver biopsy-proven NASH	12.8 ± 2.9	MRI and liver biopsy	No significant correlation between MRI-measured steatosis and whole body insulin sensitivity index
Fitzpatrick et al[33]	40 liver biopsy-proven NAFLD	10-16	Liver biopsy	68% showed insulin resistance. HOMA-R values did not correlate with NAS
Nobili et al[34]	30 NAFLD patients (11:19; without:with steatohepatitis)	8-14	Liver biopsy	HOMA-R values and insulin sensitivity indices did not correlate with steatohepatitis
El-Koofy et al[35]	18 patients with normal histology, 8 simple steatosis patients, and 7 NASH patients	2-15	Liver biopsy	HOMA-R values significantly differed between patients with normal histology and those with steatosis/NASH, and significantly correlated with grading based on US
Patton et al[36]	88 NAFLD patients	6-17	Liver biopsy	NASH vs not NASH: HOMA-R OR = 1.283 (P-value = 0.004) and QUICKI OR = 0.786 (P-value < 0.001)
Ko et al[37]	80 NAFLD patients (18 simple steatosis, 27 type 1 NASH, and 35 type 2 NASH)	10.4 ± 3.9, 12.6 ± 2.4, 12.3 ± 2.3, respectively	Liver biopsy	No differences in HOMA-R values between type 1 and type 2 NASH; HOMA-R values did not correlate with NAS
Manco et al[38]	82 NAFLD patients	3-18	Liver biopsy	HOMA-R and QUICKI values, and HOMA-beta secretion did not correlate with NAS
Nobili et al[39]	72 NAFLD patients	9-18	Liver biopsy	HOMA-R values did not correlate with NAS, steatosis, inflammation, ballooning, or fibrosis
Chan et al[40]	65 fatty liver patients	9.5-14	Liver biopsy and US	HOMA-R and QUICKI values correlated with severity of fatty liver evaluated by US. Higher insulin resistance significantly correlated with fatty liver severity only in male subjects with NASH

NAS: NAFLD activity score; US: Ultrasound; QUICKI: Quantitative insulin sensitivity check index; HOMA-R: Homeostasis model assessment as an index of insulin resistance; NASH: Nonalcoholic steatohepatitis; NAFLD: Nonalcoholic fatty liver disease; MRI: Magnetic resonance imaging.