Increasing prevalence of nonalcoholic fatty liver disease among United States adolescents, 1988-1994 to 2007-2010.
OBJECTIVE
To assess recent trends in nonalcoholic fatty liver disease (NAFLD) prevalence among US adolescents.


METHODS
Cross-sectional data from 12 714 12-19 year olds (exclusions: chronic hepatitis, hepatotoxic medications) in the National Health and Examination Survey between 1988-1994 and 2007-2010 were used to estimate trends in suspected NAFLD, defined as overweight (body mass index ≥85th percentile) plus elevated alanine aminotransferase levels (boys >25.8 U/L; girls >22.1 U/L). Linear trends in prevalence and the independent effect of demographic indicators and adiposity on NAFLD risk were tested using regression models. Complex sampling methods and P values of <.05 were used to assess statistical significance.


RESULTS
Suspected NAFLD prevalence (SE) rose from 3.9% (0.5) in 1988-1994 to 10.7% (0.9) in 2007-2010 (P < .0001), with increases among all race/ethnic subgroups, males and females, and those obese (P trend ≤.0006 for all). Among those obese, the multivariate adjusted odds of suspected NAFLD were higher with increased age, body mass index, Mexican American race, and male sex; the adjusted odds in 2007-2010 were 2.0 times those in 1988-1994. In 2007-2010, 48.1% (3.7) of all obese males and 56.0% (3.5) of obese Mexican American males had suspected NAFLD.


CONCLUSIONS
Prevalence of suspected NAFLD has more than doubled over the past 20 years and currently affects nearly 11% of adolescents and one-half of obese males. The rapid increase among those obese, independent of body mass index, suggests that other modifiable risk factors have influenced this trend.
Department of Pediatrics, Gastroenterology, Hepatology and Nutrition, Emory University School of Medicine, Atlanta, GA, USA.
Jean A
JA
Welsh
Saul
S
Karpen
Miriam B
MB
Vos
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D002648:Child; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D050177:Overweight / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D000410:Alanine Transaminase