Epidemiology

Fatty liver common in children

Last Updated: 2006-11-03 15:22:55 -0400 (Reuters Health)

NEW YORK (Reuters Health) - 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 the October issue of Pediatrics.

"The growing epidemic of childhood obesity has prompted studies of the prevalence of obesity-related conditions, such as hypertension, hypercholesterolemia, and the metabolic syndrome," Dr. Jeffrey B. Schwimmer, of the University of California, San Diego, and colleagues write. "Reports of pediatric fatty liver disease and steatohepatitis 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 histology in a population-based sample of children and adolescents. A retrospective 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 at least 5% of hepatocytes containing macrovesicular fat.

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

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

Fatty liver prevalence increased with age (range 0.7% for ages 2 to 4 to 17.3% for ages 15 to 19 years), and differs significantly by race and ethnicity (Hispanic: 11.8%; Asian: 10.2%; white: 8.6%; and black: 1.5%), 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," Dr. Schwimmer's team concludes.

Pediatrics 2006;118:1388-1393.