title: Prevalence of non-alcoholic fatty liver disease in children and relationship to metabolic syndrome, insulin resistance, and waist circumference.
abstract: OBJECTIVE
  To investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) in children and its relationship to metabolic syndrome, insulin resistance, and waist circumference (WC).
  
  
  METHODS
  This was a population-based cross-sectional, case-control study. Cases were selected among students of a primary and junior high school, respectively, and age- and sex-matched control subjects were selected randomly (ratio of cases to control subject was 37:113).
  
  
  RESULTS
  Of the 846 students, aged between 6 and 15 years, enrolled in the study and screened by ultrasonography, 37 children were diagnosed as having NAFLD (score >/= 1). There was a significant sex difference in the prevalence of NAFLD(P = 0.003). The trend test revealed a strong dose-response relationship (P < 0.001) between pediatric NAFLD and the number of the proposed components of pediatric metabolic syndrome in Japan (MetS-JC), such as a clustering of the components of MetS-JC. Additionally, the linear trend of the odds ratios (ORs) with increasing percentile of the homeostasis model assessment-insulin resistance (HOMA-IR) was statistically significant (P < 0.001). However, when WC was added to the logistic model, the ORs were no longer significant, whereas WC turned out to be an independent risk factor for NAFLD regardless of the HOMA-IR index.
  
  
  CONCLUSIONS
  The prevalence of NAFLD in children and adolescents is closely related to metabolic syndrome, insulin resistance, and WC.
authors: Department of Epidemiology and Environmental Health, Juntendo University School of Medicine, Juntendo University, Tokyo, Japan, tominaga@lomalinda-jp.com
authors: Kunihiko
authors: K
authors: Tominaga
authors: Edward
authors: E
authors: Fujimoto
authors: Keiko
authors: K
authors: Suzuki
authors: Masayuki
authors: M
authors: Hayashi
authors: Masao
authors: M
authors: Ichikawa
authors: Yutaka
authors: Y
authors: Inaba