Prevalence of NAFLD Increasing Among American Adolescents

Caroline Helwick

May 18, 2012

May 18, 2012 (San Diego, California) — Approximately 10% of adolescents in the United States are suspected of having nonalcoholic fatty liver disease (NAFLD), according to researchers who reported their findings here at Digestive Disease (DDW) Week 2012.

NAFLD can lead to liver damage, diabetes, hypertension, and cancer. The common perception has been that NAFLD is increasing among youth, but previous studies have not confirmed this. Some researchers have suggested that, if this perception is true, higher rates of NAFLD might be linked to the rise in obesity in children.

Miriam Vos, MD, from Emory University and Children's Healthcare in Atlanta, Georgia, and colleagues reviewed data on 10,359 adolescents 12 to 18 years of age from the National Health and Examination Survey, spanning 1988 to 2008. Suspected NAFLD was defined as a body mass index at least in the 85th percentile and elevated alanine aminotransferase (ALT; above 25.8 U/L for boys and above 22.1 U/L for girls). To allow for comparisons with earlier studies, they also analyzed the data based on ALT levels above 30.0 U/L.

The rate of suspected NAFLD increased from 3.6% to 9.9% over the study period (P < .0001), and obesity rates increased from 11.2% to 20.6% (P < .0001). The increase in suspected NAFLD occurred primarily in obese adolescents, but the rise was more rapid than the increase in obesity itself. ALT was elevated consistently in about 13% of overweight adolescents, with no significant change over time; among obese adolescents, the prevalence of elevated ALT increased 120% over the 20-year period, from 16.7% to 36.9% (P = .006).

"We found that the increase in NAFLD was not determined by the number of overweight children," Dr. Vos said.

DDW council chair Lawrence Friedman, MD, who is chair of the Department of Medicine at Newton–Wellesley Hospital in Newton, Massachusetts, said: "Certainly, adult gastroenterologists are seeing more and more patients with NAFLD. It's really an epidemic. This study suggests that this is occurring in the pediatric population as well, and it is best to identify it early. Sooner or later, these patients will need treatment, so I think there will be work for both pediatric and adults gastroenterologists."

Dr. Vos and Dr. Friedman have disclosed no relevant financial relationships.

Digestive Disease Week (DDW) 2012: Abstract 705. Presented May 18, 2012

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