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Fatty liver common in children Fatty liver common in children

Fatty liver common in children

Children's HealthNov 03, 2006

Fatty liver is seen in about 1 of every 10 in children and adolescents, making it the most common liver abnormality in this age group, according to findings published in current issued of the journal Pediatrics.

“The growing epidemic of childhood obesity has prompted studies of the prevalence of obesity-related conditions,” including High Blood Pressure, High cholesterol and the metabolic syndrome, a cluster of symptoms, such as diabetes, obesity and High Blood Pressure, Dr. Jeffrey B. Schwimmer, of the University of California, San Diego, and colleagues write. “Reports of pediatric fatty liver disease and steatohepatitis (fatty inflammation of the liver) in obese children have been increasing and include cases of cirrhosis and liver transplantation.”

The researchers examined the prevalence of pediatric fatty liver as diagnosed by examination of the liver tissue in a population-based sample of children and adolescents. A review was performed of 742 subjects (ages 2 to 19 years) who had an autopsy performed from 1993 to 2003. The team defined fatty liver as fatty deposits in at least 5 percent of the liver cells.

Fatty liver was present in 97 subjects (13 percent). The researchers found that the prevalence of fatty liver in children and adolescents ages 2 to 19 years was 9.6 percent after adjusting for the effects of age, gender, race, and ethnicity.

Fatty liver was not observed in underweight children, but was noted in 5 percent of normal weight children, 16 percent of overweight children, and 38 percent of obese children. Of the 97 subjects with fatty liver, 22 (23 percent) also had steatohepatitis.

The prevalence of fatty liver increased with age, ranging from 0.7 percent (ages 2 through 4 years old) to 17.3 percent (ages 15 through 19 years old), and differed significantly by race and ethnicity (Hispanic: 11.8 percent; Asian: 10.2 percent; white: 8.6 percent; and black: 1.5 percent), the team reports.

“Given the large number of children affected, it is imperative that we establish a better understanding of the natural history of pediatric fatty liver not only in terms of the progression of liver disease but also regarding its potential relationship with other health outcomes, such as type 2 diabetes mellitus and cardiovascular disease,” Schwimmer’s team concludes.

SOURCE: Pediatrics, October 2006.

Provided by ArmMed Media
Revision date: July 8, 2011
Last revised: by Tatiana Kuznetsova, D.M.D.

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Fatty liver disease causes a particular pattern of liver damage in children, with the most severe injury being seen in children who are nonwhite, boys, or those who are especially obese. However, physicians should be alert for this disease in any overweight or obese child, according to researchers here at Digestive Disease Week.

“The most common serious consequence of childhood obesity is fatty liver disease, and more than one million kids have it,” said Jeffrey Schwimmer, MD, from Children’s Hospital and Health Center and the Weight and Wellness Center, both in San Diego, California. “I think this is an underrecognized disease by pediatricians and the general public. All obese children should be screened.”

Dr. Schwimmer’s study involved 100 children (35 girls and 65 boys, aged 2 to 18 years [mean age, 12 years]) who had nonalcoholic fatty liver disease (NAFLD) as demonstrated by liver biopsy. Of these children, one was underweight, one was of healthy weight, six were overweight and 92 were obese, yielding a mean body mass index of 31.6 kg/m 2 overall. The racial distribution was 78 whites, 11 Asians, five Native American, four blacks, and two unclassified children.

The biopsies were further classified by whether they also showed type 1 or type 2 nonalcoholic steatohepatitis (NASH), a more specific finding than NAFLD. Biopsies with type 2 NASH showed significantly greater steatosis than those with type 1 NASH ( P = .01). Type 2 was also more common than type 1, affecting 41 children compared with 12 children for type 1. All seven biopsies showing advanced cirrhosis or fibrosis were for children with type 2 NASH.

Demographically, children with type 2 NASH were significantly more obese than those who had type 1 ( P < .01), more likely to be male than female (51% vs. 23%; P < .01), and were more likely to be nonwhite ( P < .001).

“The importance of this paper is that there are different patterns of NASH and NAFLD in kids” that went previously unrecognized, Bruce Bacon, MD, told Medscape. Dr. Bacon is president of the American Association for the Study of Liver Diseases and on the faculty of the St. Louis University School of Medicine in Missouri.

“But the bigger story is how prevalent these conditions are in the pediatric population,” Dr. Bacon said. “This is a slowly progressive disease. By the time these teenagers are 30 or 40, they will have complications of liver disease and/or be candidates for a liver transplant. This has significant long-term implications.”

This study was independently funded. The authors report no pertinent financial disclosures.

posted by karaciger yaglanmasi on 04/03/2010 at 10:18 am -08:00

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