{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:30:41Z","timestamp":1790231441431,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T00:00:00Z","timestamp":1720396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Prevalence of metabolic dysfunction\u2010associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), and its sequelae of more severe forms such as metabolic dysfunction\u2010associated steatohepatitis (MASH) is rapidly increasing in children with the rise in obesity. Successful and sustainable treatments for MASLD are lacking in children. We determined the therapeutic effect of\n                      <jats:italic>N<\/jats:italic>\n                      \u2010acetyl cysteine (NAC) on biomarkers of oxidative stress, inflammation and insulin resistance (IR), liver enzymes, liver fat fraction (LFF) and liver stiffness (LS) in children with obesity and biopsy\u2010confirmed MASLD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Thirteen children (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913; age: 13.6\u2009\u00b1\u20092.8 years; NAS score &gt;2) underwent a double\u2010blind, placebo\u2010controlled trial of NAC (either 600 or 1200\u2009mg NAC\/day) or placebo for 16 weeks. Measurements included LFF (magnetic resonance imaging), LS (ultrasound elastography), and body composition. Erythrocyte glutathione (GSH), liver enzymes, insulin, glucose, adiponectin, high\u2010sensitivity c\u2010reactive protein (hs\u2010CRP), and interleukin\u20106 (IL\u20106) were also measured.  homeostasis model assessment for insulin resistance (HOMA\u2010IR) was calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixteen\u2010week NAC treatment improved (baseline adjusted between\u2010group\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.05 for all) markers of inflammation (IL\u20106 and hs\u2010CRP), oxidative stress (GSH), and IR (HOMA\u2010IR) and reduced liver enzymes, LFF and LS. Body weight and body composition did not show beneficial changes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sixteen\u2010week NAC treatment was well tolerated in children with obesity and MASLD and led to improvements in oxidative stress, inflammation and IR and liver outcomes. The results from this pilot study support further investigation of NAC as a therapeutic agent in children with MASLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.12312","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T03:35:33Z","timestamp":1720409733000},"page":"652-660","source":"Crossref","is-referenced-by-count":19,"title":["Effect of\n                    <i>N<\/i>\n                    \u2010acetyl cysteine in children with metabolic dysfunction\u2010associated steatotic liver disease\u2014A pilot study"],"prefix":"10.1002","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6940-0772","authenticated-orcid":false,"given":"P.","family":"Babu Balagopal","sequence":"first","affiliation":[{"name":"Department of Research and Pediatrics Nemours Children's Health Jacksonville Florida USA"},{"name":"Department of Pediatrics Mayo Clinic College of Medicine Rochester Minnesota 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