26 - World Journal of Gastroenterology

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15S): A4577 63 Gruenwald V, Wilkens LGM, Greten TF, Kubicka S, Ganser A, Manns MP, Malek NP. A phase II open-label study of cetuximab in unresectable hepatocellular carcinoma: Final results. J Clin Oncol 2007; 25 [18S], 4598 64 Zhu AX, Stuart K, Blaszkowsky LS, Muzikansky A, Reitberg DP, Clark JW, Enzinger PC, Bhargava P, Meyerhardt JA, Horgan K, Fuchs CS, Ryan DP. Phase 2 study of cetuximab in patients with advanced hepatocellular carcinoma. Cancer 2007; 110: 581-589 65 Philip PA, Mahoney MR, Allmer C, Thomas J, Pitot HC, Kim G, Donehower RC, Fitch T, Picus J, Erlichman C. Phase II study of Erlotinib (OSI-774) in patients with advanced hepatocellular cancer. J Clin Oncol 2005; 23: 6657-6663 66 Thomas MB, Chadha R, Glover K, Wang X, Morris J, Brown T, Rashid A, Dancey J, Abbruzzese JL. Phase 2 study of erlotinib in patients with unresectable hepatocellular carcinoma. 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Efficacy, safety, and potential biomarkers of sunitinib monotherapy in advanced hepatocellular carcinoma: a phase II study. J Clin Oncol 2009; 27: 3027-3035 74 Faivre S, Raymond E, Boucher E, Douillard J, Lim HY, Kim WJG|www.wjgnet.com Welker MW et al . Anti-angiogenesis in HCC JS, Zappa M, Lanzalone S, Lin X, Deprimo S, Harmon C, Ruiz-Garcia A, Lechuga MJ, Cheng AL. Safety and efficacy of sunitinib in patients with advanced hepatocellular carcinoma: an open-label, multicentre, phase II study. Lancet Oncol 2009; 10: 794-800 75 Hoda D, Catherine C, Strosberg J, Valone T, Jump H, Campos T, Halina G, Wood G, Hoffe S, Garrett CR. Phase II study of sunitinib malate in adult pts (pts) with metastatic or surgically unresectable hepatocellular carcinoma (HCC). 2008 Gastrointestinal Cancers Symposium, A267 76 Sun W, Haller DG, Mykulowycz K, Rosen M, Soulen M, Capparo M, Faust T, Giantonia B, Olthoff K. 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Invest New Drugs 2008; 26: 193-194 83 Abou-Alfa GK, Johnson P, Knox JJ, Capanu M, Davidenko I, Lacava J, Leung T, Gansukh B, Saltz LB. Doxorubicin plus sorafenib vs doxorubicin alone in patients with advanced hepatocellular carcinoma: a randomized trial. JAMA 2010; 304: 2154-2160 84 Richly H, Schultheis B, Adamietz IA, Kupsch P, Grubert M, Hilger RA, Ludwig M, Brendel E, Christensen O, Strumberg D. Combination of sorafenib and doxorubicin in patients with advanced hepatocellular carcinoma: results from a phase I extension trial. Eur J Cancer 2009; 45: 579-587 S- Editor Tian L L- Editor O’Neill M E- Editor Ma WH 3081 July 14, 2011|Volume 17|Issue 26|
Online Submissions: http://www.wjgnet.com/1007-9327office wjg@wjgnet.com doi:10.3748/wjg.v17.i26.3082 Pediatric nonalcoholic fatty liver disease, metabolic syndrome and cardiovascular risk Lucia Pacifico, Valerio Nobili, Caterina Anania, Paola Verdecchia, Claudio Chiesa Lucia Pacifico, Caterina Anania, Paola Verdecchia, Department of Pediatrics, Sapienza University of Rome, 00161-Rome, Italy Valerio Nobili, Department of Hepato-gastroenterology and Nutrition, Pediatric Hospital “Bambino Gesù”, Rome, Italy Claudio Chiesa, Institute of Translational Pharmacology, National Research Council, 00133-Rome, Italy Author contributions: Pacifico L, Anania C and Chiesa C designed the study; Anania C, Verdecchia P and Nobili V were responsible for acquisition, analysis and interpretation of data; Pacifico L, Anania C and Verdecchia P drafted the manuscript; Pacifico L, Nobili V and Chiesa C prepared the final version of the manuscript; Chiesa C and Nobili V critically revised the manuscript for important intellectual content; all authors approved the final version of the manuscript. Correspondence to: Claudio Chiesa, MD, Institute of Translational Pharmacology, National Research Council, Via del Fosso del Cavaliere, 100, I-00133 Rome, Italy. claudio.chiesa@ift.cnr.it Telephone: +39-6-49979215 Fax: +39-6-49979216 Received: February 2, 2011 Revised: March 21, 2011 Accepted: March 28, 2011 Published online: July 14, 2011 Abstract Nonalcoholic fatty liver disease (NAFLD) encompasses a range of liver histology severity and outcomes in the absence of chronic alcohol use. The mildest form is simple steatosis in which triglycerides accumulate within hepatocytes. A more advanced form of NAFLD, nonalcoholic steatohepatitis, includes inflammation and liver cell injury, progressive to cryptogenic cirrhosis. NAFLD has become the most common cause of chronic liver disease in children and adolescents. The recent rise in the prevalence rates of overweight and obesity likely explains the NAFLD epidemic worldwide. NAFLD is strongly associated with abdominal obesity, type 2 diabetes, and dyslipidemia, and most patients have evidence of insulin resistance. Thus, NAFLD shares many features of the metabolic syndrome (MetS), a highly atherogenic condition, and this has stimulated interest in the possible role of NAFLD in the development of atherosclerosis. Accumulating evidence suggests that WJG|www.wjgnet.com 3082 World J Gastroenterol 2011 July 14; 17(26): 3082-3091 ISSN 1007-9327 (print) ISSN 2219-2840 (online) © 2011 Baishideng. All rights reserved. REVIEW NAFLD is associated with a significantly greater overall mortality than in the general population, as well as with increased prevalence of cardiovascular disease (CVD), independently of classical atherosclerotic risk factors. Yet, several studies including the pediatric population have reported independent associations between NAFLD and impaired flow-mediated vasodilatation and increased carotid artery intimal medial thickness-two reliable markers of subclinical atherosclerosis-after adjusting for cardiovascular risk factors and MetS. Therefore, the rising prevalence of obesity-related MetS and NAFLD in childhood may lead to a parallel increase in adverse cardiovascular outcomes. In children, the cardiovascular system remains plastic and damage-reversible if early and appropriate interventions are established effectively. Therapeutic goals for NAFLD should address nutrition, physical activity, and avoidance of smoking to prevent not only end-stage liver disease but also CVD. © 2011 Baishideng. All rights reserved. Key words: Nonalcoholic fatty liver disease; Metabolic syndrome; Cardiovascular risk; Children Peer reviewers: Eyvind J Paulssen, MD, PhD, Department of Gastroenterology, University Hospital of North Norway, PO Box 83, Tromsø, N-9038, Norway; Yoshihisa Takahashi, MD, Department of Pathology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan Pacifico L, Nobili V, Anania C, Verdecchia P, Chiesa C. Pediatric nonalcoholic fatty liver disease, metabolic syndrome and cardiovascular risk. World J Gastroenterol 2011; 17(26): 3082-3091 Available from: URL: http://www.wjgnet.com/1007-9327/full/v17/ i26/3082.htm DOI: http://dx.doi.org/10.3748/wjg.v17.i26.3082 INTRODUCTION Over the last two decades, the rise in the prevalence rates of overweight and obesity may explain the emergence of nonalcoholic fatty liver disease (NAFLD) as the leading July 14, 2011|Volume 17|Issue 26|
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