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Nonalcoholic fatty liver disease in overweight children and adolescents
Author(s) -
Sagi R,
Reif S,
Neuman G,
Webb M,
Phillip M,
Shalitin S
Publication year - 2007
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2007.00399.x
Subject(s) - medicine , fatty liver , steatosis , nonalcoholic fatty liver disease , gastroenterology , overweight , obesity , liver disease , population , insulin resistance , disease , environmental health
Objective: To investigate the prevalence and characteristics of non‐alcoholic fatty liver disease (NAFLD) and identify predictors for NAFLD in an overweight paediatric population. Methods: The study group included 58 overweight (BMI‐SDS 3.37 ± 1) patients aged 8–18 years attending the paediatric obesity clinic. They underwent a clinical and biochemical work‐up and liver ultrasonography. Grading of liver steatosis severity was done according to discrepancy in ultrasonographic liver‐kidney densities. Results: The prevalence of NAFLD was 60.3%. There was a highly significant (p = 0.004) association between severity of obesity and the presence or absence of liver steatosis. The study cohort was divided into three groups: group 1 (patients with normal ultrasonographic liver structure and normal liver enzymes), group 2 (patients with ultrasonographic fatty liver and normal liver enzymes) and group 3 (patients with ultrasonographic fatty liver and elevated liver enzymes). The BMI‐SDS was significantly higher in group 3 compared to group 1 (4.2 ± 1.1 vs. 2.8 ± 0.9, p < 0.001). The rate of obesity complications was more prevalent in group 3 compared to groups 1 and 2 (p < 0.001). The insulin resistance index was higher in group 3 compared to group 1 (0.75 ± 0.2 vs. 0.47 ± 0.3, p < 0.05). Conclusions: The prevalence of NAFLD in our study cohort was high (60.3%). Patients with steatosis and elevated liver enzymes had a higher risk for obesity complications. Measurements of liver enzymes alone are insufficient, and liver ultrasonography is required for early identification of NAFLD.