Fatty liver common in children

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.