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Comparative efficacy of different treatment modalities in the management of pediatric non-alcoholic fatty liver disease: A systematic review and network meta-analysis

医学 脂肪肝 荟萃分析 心理干预 梅德林 疾病 天冬氨酸转氨酶 丙氨酸转氨酶 内科学 重症监护医学 精神科 生物化学 化学 碱性磷酸酶 政治学 法学
作者
Xenophon Theodoridis,Georgios Kalopitas,Andreas Vadarlis,Dimitra Rafailia Bakaloudi,Νikolaos Gkiourtzis,Georgios Dionysopoulos,Evangelia Karanika,Eirini Tsekitsidi,M. Chourdakis
出处
期刊:Pharmacology & Therapeutics [Elsevier]
卷期号:240: 108294-108294 被引量:5
标识
DOI:10.1016/j.pharmthera.2022.108294
摘要

The incidence of non-alcoholic fatty liver disease (NAFLD) in children is constantly rising. Lifestyle modification is the cornerstone of the management of pediatric NAFLD. Even though several clinical trials have been conducted, there are barely any approved medications or supplements that can be used in the management of pediatric NAFLD. The aim of our study was to systematically review the current literature and perform a network meta-analysis to compare the different treatment interventions in pediatric NAFLD. Pubmed/Medline, Embase and Scopus were searched from inception to 2 December 2021. The primary outcomes were changes in alanine transaminase (`concentrations. Secondary outcomes were changes in aspartate aminotransferase (AST), lipidemic and other biochemical parameters concentrations and body mass index (BMI) values. The evaluation of transitivity was performed by comparing the distribution of potential effect modifiers across the difference comparisons. Our study included 1241 participants from 18 studies. Different interventions such as omega 3 fatty acids and probiotics seem to exert possible beneficial effects in the management of pediatric NAFLD. Vitamin D and vitamin E supplementation alone or in combination with other interventions also seem to be beneficial in specific patient groups. Several interventions such as omega-3 fatty acids, probiotics and vitamin D and E can be combined with lifestyle modification to manage pediatric NAFLD. Decisions should be individualized based on the patient's profile. Future studies with optimal methodology are needed to draw safe and applicable conclusions.
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