Prevalence of Suspected Nonalcoholic Fatty Liver Disease in Lean Adolescents in the United States

Abstract

The estimated prevalence of suspected NAFLD among lean adolescents in the US was found to be 8% with evidence of metabolic derangements such as low HDL, hypertriglyceridemia, and IR.

Epidemiology of Pediatric Nonalcoholic Fatty Liver Disease

“…NAFLD also occurs in children without obesity. In a nationally representative sample of adolescents with normal body mass index percentile, 8% had unexplained liver chemistry elevation that was interpreted as suspected NAFLD 12 …”

From Nonalcoholic Fatty Liver Disease (NAFLD) to Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)—New Terminology in Pediatric Patients as a Step in Good Scientific Direction?

“…Recent data have shown that normal body weight does not protect from the development of NAFLD and it can also occur in non-obese individuals [73,74]. The incidence of lean NAFLD in adolescents ranging from 8% in the USA to 16% in the Asia-Pacific region [75]. According to MAFLD criteria, we are able to diagnose it also in non-overweight and non-obese patients, when we confirm a presence of liver steatosis with at least two mentioned above metabolic risk abnormalities.…”

A review of non‐alcoholic fatty liver disease in non‐obese and lean individuals

“…The largest epidemiological study on lean NAFLD in Caucasian adults in the USA analyzed the data of the National Health and Nutrition Examination Survey III (NHANES III) and reported a prevalence of 7.4% for ultrasonography‐detected hepatic steatosis in non‐obese cases (BMI < 25 kg/m 2 ), which was substantially lower compared with 27.7% in overweight/obese subjects 21 . Furthermore, a recent cross‐sectional study on adolescents showed that suspected lean NAFLD could be a threat to all age groups 22 . Data from 1482 lean individuals (BMI less than 85th percentile) aged between 12 and 18 years, who were enrolled in the NHANES during the 2005 to 2014 cycles, found that 8% of the subjects were suspected of NAFLD (defined by alanine aminotransferase [ALT] > 22.1 U/L for girls and > 25.8 U/L for boys) 22 .…”

“…Furthermore, a recent cross‐sectional study on adolescents showed that suspected lean NAFLD could be a threat to all age groups 22 . Data from 1482 lean individuals (BMI less than 85th percentile) aged between 12 and 18 years, who were enrolled in the NHANES during the 2005 to 2014 cycles, found that 8% of the subjects were suspected of NAFLD (defined by alanine aminotransferase [ALT] > 22.1 U/L for girls and > 25.8 U/L for boys) 22 . They also reported a higher rate of hypertriglyceridemia, insulin resistance (IR), and low high‐density lipoprotein among lean NAFLD patients compared with their non‐NAFLD counterparts 22 …”