title: Predictors of non-alcoholic fatty liver disease in obese and overweight Egyptian children: single center study.
abstract: OBJECTIVE
  Pediatric non-alcoholic fatty liver disease (NAFLD) is a global problem which has been increasingly recognized with the dramatic rise in pediatric obesity. The aim of the present study was to identify the clinical, sonographic, and biochemical predictors for NAFLD in obese children.
  
  
  METHODS
  Seventy-six children (2-15 years) were included after an informed consent. All were subjected to full anthropometric assessment (including height, weight, body mass index, subscapular skin fold thickness, waist and hip circumference and calculation of waist: hip ratio), biochemical assessment of liver function tests, lipid profile and insulin resistance and sonographic assessment of hepatic echogenicity. Liver biopsy when indicated, was done in 33 patients.
  
  
  RESULTS
  Sixteen patients (21%) had elevated ALT and 6 (7.9%) had elevated AST. Significant dyslipidemia (low HDL-c, high total cholesterol, high LDL-c and triglycerides) and higher insulin resistance were found in obese patients (P<0.01). The main sonographic findings were hepatomegaly in 20 patients (26.3%) and echogenic liver in 41 patients (53.9%). Liver biopsy showed simple steatosis in eight cases (24.2%) and non-alcoholic steatohepatitis (NASH) in seven cases (21.2%). Anthropometric measurements, increased hepatic echogenicty by ultrasound, insulin resistance and lipid profile were good predictors of NAFLD in obese children if assessed together. However, LDL-c was the only sensitive predictor (independent variable) for NAFLD in both uni- and multivariate logistic regression analyses.
  
  
  CONCLUSIONS
  Dyslipidemia per se is a strong predictor of NAFLD among obese Egyptian children.
authors.affiliation: Department of Pediatrics, Cairo University, Research Institute of Ophthalmology, Egypt. hanaakaraksy@yahoo.com
authors.forename: Hanaa M
authors.initials: HM
authors.lastname: el-Karaksy
authors.forename: Nehal M
authors.initials: NM
authors.lastname: el-Koofy
authors.forename: Ghada M
authors.initials: GM
authors.lastname: Anwar
authors.forename: Fatma M
authors.initials: FM
authors.lastname: el-Mougy
authors.forename: Ahmed
authors.initials: A
authors.lastname: el-Hennawy
authors.forename: Mona E
authors.initials: ME
authors.lastname: Fahmy
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004534:Egypt; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D008111:Liver Function Tests; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D008055:Lipids