Clinically Meaningful Body Mass Index Change Impacts Pediatric Nonalcoholic Fatty Liver Disease

• Published in: The Journal of pediatrics 2022-11, Vol.250, p.61-66.e1
• Main Authors: Khurana, Tarush, Klepper, Corie, Fei, Lin, Sun, Qin, Bramlage, Kristin, Arce-Clachar, Ana Catalina, Xanthakos, Stavra, Mouzaki, Marialena
• Format: Article
• Language: English
• Subjects: Adolescent; Alanine Transaminase; Body Mass Index; Child; children; Female; Hispanic or Latino; Humans; Male; NAFLD; Non-alcoholic Fatty Liver Disease - epidemiology; obesity; Retrospective Studies; weight; Weight Gain
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2022.07.004

To investigate the prevalence and characteristics of children with nonalcoholic fatty liver disease (NAFLD) who reduce their body mass index (BMI) z-score (BMIz) by >.25, a goal in obesity medicine, and to determine the BMIz decrease needed for serum aminotransferase normalization. This retrospective, single-center study included patients aged −.25, as well as predictors of this outcome. Of the 784 children who met the study criteria (median age, 13 years; 66% male; 24% Hispanic), 541 had a lowest BMIz at >90 days following the baseline clinic visit. Of these children, 168 (31%) had a BMIz change of >−.25 from baseline over a median of 367 days (IQR, 201-678 days). Decreases in serum aminotransferase and lipid levels were seen in both groups (with and without a BMIz change of >−.25); however, these decreases were more pronounced in children who achieved a BMIz drop of >.25. Hemoglobin A1c concentration did not change in either group. Young age (OR, .861; 95% CI, .81-.92; P .25 is associated with significant changes in serum aminotransferase levels. These findings can further guide the clinical management of children with NAFLD.