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NAFLD common among children in UK

Nonalcoholic fatty liver disease is prevalent among children and adolescents in the United Kingdom, particularly among males considered clinically obese, according to published findings.

“Here we report results of a systematic review and meta-analysis of studies reporting the prevalence of NAFLD in children and adolescents aged between 1 and 19 years, in the general population and in populations of clinically obese adolescents,” the researchers wrote. “We aimed to estimate the prevalence of NAFLD in young people and to determine whether and how this varies over time, by BMI category, gender, age, diagnostic method, geographical region and study sample size.”

Researchers from the University of Bristol and University of York conducted the systematic review and meta-analysis using 74 studies reporting a prevalence of NAFLD among children. In the studies, patient populations ranged from seven to 6,895, with a median of 87. Eighteen studies, with 20 independent study populations, were conducted in general populations, and 56 studies were conducted in clinical populations of obese children and adolescents, with 56 independent study populations.

Overall, the mean prevalence of NAFLD in children from the general population studies was 7.6% (95% CI, 5.5-10.3%), but jumped to 34.2% (95% CI, 27.8-41.2%) in studies examining patients in childhood obesity clinics. Marked heterogeneity was observed in both populations of patients (I² = 98%).

“Although there was considerable heterogeneity between studies which was not adequately explained by a range of study characteristic, our review provides the best and most comprehensive estimate of NAFLD prevalence in young people in the general population and in clinical obese populations to date, and importantly, allows the comparison of prevalence between various groups of interest,” the researchers wrote.

The prevalence estimates for NAFLD were found to be lower for each population when elevated alanine aminotransferase serum was used to assess NAFLD compared with biopsies, ultrasound scans or MRI.

“There was evidence that prevalence was generally higher in males compared with females and increased incrementally with greater BMI … [as well as] evidence for differences between regions in clinical population studies, with estimated prevalence being highest in Asia,” the researchers wrote. “Providing prevalence separately in females and males and by ethnicity may also provide a better understanding of how NAFLD prevalence varies between different populations.

“Finally, given that sensitivity and specificity are lower for ALT than for MRI, and that prevalence estimates were similar for [ultrasound scan] and MRI, our results tentatively suggest that ALT may underestimate NAFLD prevalence in young obese people, and overestimate prevalence in the general population.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.