Nonalcoholic fatty liver disease in overweight children and adolescents.
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.
Sagi
R
R
Department of Pediatrics, and Pediatric Gastroenterology Unit, Dana Children's Hopsital, Tel Aviv, Israel.
Reif
S
S
Neuman
G
G
Webb
M
M
Phillip
M
M
Shalitin
S
S
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D050177:Overweight; D015995:Prevalence; D012720:Severity of Illness Index; D012737:Sex Factors; D013548:Sweden; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography
D007328:Insulin; D020738:Leptin; D014280:Triglycerides; D000410:Alanine Transaminase