Prevalence of Nonalcoholic Fatty Liver Disease in Children with Obesity

To determine the prevalence of nonalcoholic fatty liver disease (NAFLD) in children with obesity because current estimates range from 1.7% to 85%. A second objective was to evaluate the diagnostic accuracy of alanine aminotransferase (ALT) for NAFLD in children with obesity. We evaluated children ag...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of pediatrics 2019-04, Vol.207, p.64-70
Main Authors: Yu, Elizabeth L., Golshan, Shahrokh, Harlow, Kathryn E., Angeles, Jorge E., Durelle, Janis, Goyal, Nidhi P., Newton, Kimberly P., Sawh, Mary Catherine, Hooker, Jonathan, Sy, Ethan Z., Middleton, Michael S., Sirlin, Claude B., Schwimmer, Jeffrey B.
Format: Article
Language:English
Subjects:
Adolescent
Alanine Transaminase - blood
Biomarkers - blood
BMI
Case-Control Studies
Child
Decision Trees
Female
Humans
Insulin - blood
Magnetic Resonance Imaging - methods
Male
NAFLD
Non-alcoholic Fatty Liver Disease - diagnostic imaging
Non-alcoholic Fatty Liver Disease - epidemiology
Obesity - epidemiology
pediatric
Predictive Value of Tests
Prevalence
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To determine the prevalence of nonalcoholic fatty liver disease (NAFLD) in children with obesity because current estimates range from 1.7% to 85%. A second objective was to evaluate the diagnostic accuracy of alanine aminotransferase (ALT) for NAFLD in children with obesity. We evaluated children aged 9-17 years with obesity for the presence of NAFLD. Diseases other than NAFLD were excluded by history and laboratories. Hepatic steatosis was measured by liver magnetic resonance imaging proton density fat fraction. The diagnostic accuracy of ALT for detecting NAFLD was evaluated. The study included 408 children with obesity that had a mean age of 13.2 years and mean body mass index percentile of 98.0. The study population had a mean ALT of 32 U/L and median hepatic magnetic resonance imaging proton density fat fraction of 3.7%. The estimated prevalence of NAFLD was 26.0% (95% CI 24.2%-27.7%), 29.4% in male patients (CI 26.1%-32.7%) and 22.6% in female patients (CI 16.0%-29.1%). Optimal ALT cut-point was 42 U/L (47.8% sensitivity, 93.2% specificity) for male and 30 U/L (52.1% sensitivity, 88.8% specificity) for female patients. The classification and regression tree model with sex, ALT, and insulin had 80% diagnostic accuracy for NAFLD. NAFLD is common in children with obesity, but NAFLD and obesity are not concomitant. In children with obesity, NAFLD is present in nearly one-third of boys and one-fourth of girls.
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2018.11.021