Intestinal permeability is increased in children with non-alcoholic fatty liver disease, and correlates with liver disease severity.

Abstract Background Increased intestinal permeability seems to play a major role in non-alcoholic liver disease development and progression. Aim To investigate the prevalence of altered intestinal permeability in children with non-alcoholic fatty liver disease, and to study its potential association with the stage of liver disease. Methods We performed a case–control study examining intestinal permeability in children using the lactulose–mannitol bowel permeability test. Results Overall, 39 consecutive patients (30 males, median age 12 years) and 21 controls (14 males, median age 11.8 years) were included. The lactulose/mannitol ratio resulted impaired in 12/39 patients (31%) and none of the controls. Intestinal permeability was higher in children with non-alcoholic fatty liver disease (lactulose/mannitol ratios: 0.038 ± 0.037 vs. 0.008 ± 0.007, p p p  = 0.02), fibrosis ( p  = 0.0002), and ballooning of hepatocytes ( p  = 0.003). Blood lipopolysaccharides levels were higher in children with steatohepatitis (2.27 ± 0.68 vs. 2.80 ± 0.35, p Conclusions Intestinal permeability is increased in children with non-alcoholic fatty liver disease, and correlates with the severity of the disease.