title: Most overweight and obese Indian children have nonalcoholic fatty liver disease.
abstract: Background and rationale. Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease in western countries. Its prevalence in Indian subcontinent is not well studied.
  
  
  METHODS
  In a school based cross sectional study we have screened overweight and obese children in the age group of 11 to 15 years for NAFLD. Ultrasonography, elevated serum transaminases, fibroscan were used for defining NAFLD. Dietary habits, blood pressure, serum lipid profile, blood counts and insulin resistance were recorded. The relation of fibrosis 4 score, pediatric NAFLD fibrosis index, aspartate transaminases to platelet ratio index (APRI) with fibroscan was evaluated.
  
  
  RESULTS
  Out of 616 students screened 198 were overweight and obese. Hundred students and their parents gave informed consent for the further evaluation. The prevalence of NAFLD was 62% in overweight and obese children. Fatty liver was found in 50 % students on ultrasonography, liver stiffness (≥ 6.1 Kilopascals) in 23% and raised alanine transaminase in 30%. Hypertension, dyslipidemia, diabetes mellitus and insulin resistance were seen in 6%, 18%, 2% and 66% students respectively. Systolic hypertension, serum triglyceride, aspartate transaminase, APRI was significantly higher in the NAFLD group. On binary logistic regression only systolic hypertension was an independent risk factor for NAFLD.
  
  
  CONCLUSIONS
  In conclusion NAFLD is common in asymptomatic overweight and obese Indian children. Systolic hypertension is the only independent factor associated with NAFLD. Fibroscan has limited role for screening. We recommend screening for NAFLD in this high risk group with alanine transaminases and ultrasonography.
authors.affiliation: Department of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Sunil V
authors.initials: SV
authors.lastname: Pawar
authors.affiliation: Department of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Vinay G
authors.initials: VG
authors.lastname: Zanwar
authors.affiliation: Department of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Ajay S
authors.initials: AS
authors.lastname: Choksey
authors.affiliation: Department of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Ashok R
authors.initials: AR
authors.lastname: Mohite
authors.affiliation: Department of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Samit S
authors.initials: SS
authors.lastname: Jain
authors.affiliation: Department of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Ravindra G
authors.initials: RG
authors.lastname: Surude
authors.affiliation: Department of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Qais Q
authors.initials: QQ
authors.lastname: Contractor
authors.affiliation: Department of Gastroenterology & Hepatology, Bombay Hospital Institute of Medical Science (BHIMS) and Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Pravin M
authors.initials: PM
authors.lastname: Rathi
authors.affiliation: Department of Radio diagnosis, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Ravi U
authors.initials: RU
authors.lastname: Verma
authors.affiliation: Department of Endocrinology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India.
authors.forename: Premlata K
authors.initials: PK
authors.lastname: Varthakavi
mesh_terms: D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D007194:India / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000175:diagnosis / Q000453:epidemiology*; D010976:Platelet Count; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D008055:Lipids; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase