Author information
1
Hepatometabolic Unit - Bambino Gesù Children's Hospital, Rome, Italy.
2
Department of Pediatrics, Facoltà di Medicina e Psicologia, Sapienza University of Rome, Italy.
3
Histopathology Unit, Bambino Gesù Hospital, IRCCS, Rome, Italy.
4
Medical Directorate, "Bambino Gesù" Children's Hospital, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico), Rome, Italy.
5
Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
6
NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom.
Abstract
BACKGROUND & AIMS:
As dietary components are delivered directly to the periportal zone of the liver lobule, there is the potential for greater injury in this zone (zone 1) compared to the perivenous zone (zone 3). We investigated the associations between dietary fructose consumption and uric acid concentrations and differential zonal injury in periportal and perivenous zones.
METHODS:
271 children's histological images were scored in five periportal and five perivenous. zones for steatosis, ballooning, inflammation, and fibrosis severity. Dietary fructose consumption (grammes/day) was assessed and uric acid measured in serum. Logistic regression was undertaken to test associations between both high fructose consumption and hyperuricaemia, and histological disease in periportal and perivenous zones.
RESULTS:
Mean age 12.5 years. Inflammation (mean±SD) was increased in the periportal versus perivenous zones (0.78 ±0.43 v.0.41±0.48, p=0.041). There were non significant trends towards greater steatosis, ballooning and fibrosis in the periportal zone. In the fully adjusted models, high fructose intake was associated with disease in both zones. E.g. for periportal and perivenous zones respectively, steatosis 1.56(1.12,2.49) and 1.21(1.09,2.73); inflammation 4.29 (2.31,5.88) and 3.69 (2.14,4.56; and fibrosis 2.72(1.43,3.76) and 1.96(1.24,2.37). Hyperuricaemia (uric acid ≥5.9mg/dL) was associated with inflammation in the periportal zone 1.71(1.17,2.35); and was associated with steatosis and fibrosis in both zones; e.g. for periportal and perivenous zones respectively, steatosis 2.98(1.65,3.23) and 1.14(1.05, 1.99); and fibrosis, 2.65(1.35,2.99) and 1.31(1.13,2.17).
CONCLUSIONS:
High fructose consumption is associated with disease severity in both lobular zones and hyperuricaemia may be associated with more severe disease in the periportal zone.