Prevalence of fatty liver in Japanese children and relationship to obesity

Abstract

The prevalence of fatty liver in children is unknown and its relationship to obesity is poorly defined. The present study of 810 northern Japanese children (4-12 years old) determined the prevalence of fatty liver in the pediatric population and its relationship to obesity. Diagnosis of fatty liver was based on established real-time ultrasonographic criteria. The overall prevalence of fatty liver was 2.6% and was higher for boys (3.4%) than for girls (1.8%), although not statistically significant (P = 0.15). Fatty liver was found in children as young as 6 years of age. There was no significant association between the prevalence of fatty liver and height (physical growth). There was a strong positive correlation between fatty liver prevalence and established obesity indices: Rohrer's Index--chi 2 linear trend = 59.2, P < 0.0001; body mass index--chi 2 linear trend = 91.6, P < 0.0001; and age-gender-adjusted Japanese standard index of weight for height--chi 2 linear trend = 93.2, P < 0.0001. However, direct measurement of abdominal subcutaneous fat thickness by ultrasonography was the best predictor of fatty liver: chi 2 linear trend = 159, P < 0.0001. These results indicate that fatty liver may develop very early in life, and there is a direct relationship between degree of obesity and fatty liver in children.

Prevalence of non-alcoholic fatty liver disease in children and relationship to metabolic syndrome, insulin resistance, and waist circumference

“…Among the entire pediatric population enrolled in this study, the prevalence of mild-serious NAFLD (score C 1) was 4.4%, with a prevalence of 6.6% in males and 2.0% in females. This result confirms the existence of a gender difference in the prevalence of NAFLD, which has also been shown in previous studies [2,9].…”

“…Rashid et al [7] reported cirrhosis in children as young as 10 years. Although results from population-based epidemiologic studies are limited, the prevalence of NAFLD seems to be higher than expected [8], and an earlier epidemiological survey carried out by our group found the prevalence of this condition among school children (4-12 years of age), as detected by ultrasonography, to be 2.6%, increasing to 22.5% among obese children [9].…”

“…The scoring of each of the three examiners was combined to make a composite score [9]. Each criterion was assigned a score that indicated the level of fatty liver infiltration, with a score of 2 indicating a distinctly positive (??)…”

Strategies for the prevention and control of obesity in the school setting: systematic review and meta-analysis

“…The physical health of obese children is compromised in a manner similar to adults. Childhood obesity is associated with an increased risk of hyperinsulinemia, 3 insulinresistance, 4 type 2 diabetes, 5,6 hypertension, 7,8 hypercholesterolemia, 3 chronic inflammation, 9 abnormalities in endothelial function, 10 hyperandrogenemia, 4 gallstones, 11 hepatitis, 12,13 asthma, cancer 14 and orthopedic problems. 10 Obesity has also been shown to diminish children's quality of life severely 14 and is associated with decreased selfesteem 15,16 and depressive symptoms.…”

Nonalcoholic fatty liver disease: a challenge for pediatricians

“…[14][15][16][17][18] Measurement of abdominal subcutaneous fat thickness by ultrasonography could be a good estimate for liver involvement, especially in obese subjects. [19][20][21][22][23] Population-based approaches by this method, suggests an overall prevalence of at least 3% for suspected fatty liver disease among children and adolescents in the United States and Asia. 9,17 The histology of the liver, the most important criterion for diagnosis is usually not being used for screening.…”