Non-alcoholic fatty liver disease in obese and overweight children

Abstract

Background: Childhood obesity is rising alarmingly and approaching an epidemic proportion in many countries. It increases the risk of developing non-communicable disease in adulthood. Non-alcoholic fatty liver disease (NAFLD) is a key co-morbidity associated with obesity and emerged as the leading cause of chronic liver disease in children. This study aimed to see the prevalence of the NAFLD with overweight and obesity among children.Methods: It was a cross sectional study conducted among children aged 5.5 to 18 years attending in the pediatric endocrinology clinic of department of pediatrics, Bangabandhu Sheikh Mujib medical university over a period of 14 months. Children’s weight and height were evaluated and then BMI was calculated for particular age and sex according to center for disease control growth chart. All obese and overweight children were included except those taking systemic steroid, or suffering from genetic, endocrine, liver or renal disease. Patients were advised to do serum alanine aminotransferase (ALT) and ultrasonography of hepatobiliary system.Results: A total of 90 children were enrolled in the study. Among them majority (93.3%) were obese and the rest were overweight (6.7%). Overall, 40% children had NAFLD including 40.5% among the obese and 33.3% among the overweight (p>0.05). Majority (91.6%) had mild NAFLD. Alanine amino transferase (ALT) level was raised significantly among children with NAFLD compared to those without NAFLD (58.3% and 16.7% respectively, p<0.001).Conclusions: More than one-third of the overweight and obese children had NAFLD with a significantly higher level of ALT compared to children without NAFLD. Therefore, NAFLD should be routinely screened among children with increased weight to take timely intervention and prevent further progression of the disease.

Non-Alcoholic Fatty Liver Disease in Obese Children: Frequency, Metabolic Profiles, and Associated Risk Factors

“…18 NAFLD is a common complication associated with obesity in children, exhibiting a prevalence that spans from 1.7% to 85%. 7,18,19 In our study, NAFLD was identified in 63.4% of obese children of the same age group, through ultrasound testing. A comparable prevalence of 62% in obese children was also reported in the study by Gupta et al This study used Indian Academy of Paediatrics guidelines to define obesity while we followed WHO`s guidelines 20 .…”

“…This finding aligns consistently with observations from various previous studies. [19][20][21][22][23][24] In our study, we noted that ALT levels ≥ 45 IU/L were present in 81.1% of patients diagnosed with NAFLD, in contrast to a lower occurrence of 18.9% in patients without NAFLD. Correspondingly, Akhtar et al, reported a significant elevation in ALT levels among children with NAFLD (58.3%) compared to those without NAFLD (16.7%).…”

“…7,25 In contrast to our study a lower prevalence of 50.8% and 40% NAFLD has been reported in previous studies. 19,26 These studies however included both overweight as well as obese children in contrast to our study which included only obese children.…”

“…24 In alignment with our results, Peng et al Gupta et al Altalebi et al and Parry et al all noted a significant association between waist circumference and NAFLD. 7,19,20,22 In contrast, Thiagarajan et al reported disparate findings, suggesting no statistically significant difference in waist circumference between individuals with and without NAFLD. 25 Our study found no notable differences in the association of NAFLD with age and gender, consistent with earlier investigations.…”