Acetaminophen pharmacokinetics in children with nonalcoholic fatty liver disease

J Pediatr Gastroenterol Nutr. 2011 Feb;52(2):198-202. doi: 10.1097/MPG.0b013e3181f9b3a0.


Objectives: : The aim of the study was to evaluate UDP-glucuronyltransferase activity and the pharmacokinetics of a single oral dose of acetaminophen (APAP) in children with nonalcoholic fatty liver disease (NAFLD).

Patients and methods: : Twelve boys 10 to 17 years old with biopsy-proven NAFLD and 12 age- and sex-matched controls without NAFLD were recruited. Following administration of a single oral dose of APAP (5 mg/kg, maximum 325 mg), APAP and its glucuronide metabolite (APAP-G) were measured in plasma, urine, and sputum at various intervals up to 24 hours. The activity of UDP-glucuronyltransferase was estimated by the plasma ratio of APAP-G to APAP at 4 hours.

Results: : Following administration of APAP, children with NAFLD had significantly higher concentrations of APAP-G in serum (P = 0.0071) and urine (P = 0.0210) compared with controls. No significant differences in APAP pharmacokinetics parameters were observed between the 2 groups.

Conclusions: : APAP glucuronidation is altered in children with fatty liver disease. Despite the altered disposition of this metabolite, the pharmacokinetics of a single 5 mg/kg dose of APAP is the same in children with NAFLD as in children with normal liver function.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acetaminophen / analogs & derivatives
  • Acetaminophen / metabolism
  • Acetaminophen / pharmacokinetics*
  • Adolescent
  • Case-Control Studies
  • Child
  • Fatty Liver / enzymology
  • Fatty Liver / metabolism
  • Fatty Liver / physiopathology
  • Glucuronosyltransferase / metabolism*
  • Humans
  • Liver / physiopathology
  • Male
  • Non-alcoholic Fatty Liver Disease
  • Statistics, Nonparametric


  • Acetaminophen
  • acetaminophen glucuronide
  • Glucuronosyltransferase