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Nonalcoholic fatty liver disease in Japanese junior high school students: its prevalence and relationship to lifestyle habits

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Despite the increase in nonalcoholic fatty liver disease (NAFLD) in Japanese adults, its prevalence in adolescents remains unclear. This prompted us to evaluate the incidence and clinical characteristics of NAFLD among junior high school students.

Methods

A population-based cross-sectional study was conducted among students in a single junior high school in Nagano prefecture. Serum alanine aminotransferase (ALT) and γ-glutamyltransferase (γGT) measurements and abdominal ultrasonography were performed in 249 and 288 students in 2004 and 2007, respectively. In the latter survey, student lifestyle habits were also assessed, using questionnaires.

Results

The prevalence of NAFLD was 4.4% and 4.5% in 2004 and 2007, respectively, which was lower than that of obesity (10.0% and 5.9%). Body mass index and ALT and γGT levels increased significantly with hepatic steatosis severity. Multivariate logistic regression analysis demonstrated that the presence of obesity and an ALT level of 30 U/L or more were independent predictors of NAFLD (odds ratio 16.9, P < 0.001 and odds ratio 16.6, P = 0.001, respectively). The ratios of students commuting to and from school by car and not doing sports outside of school were higher in NAFLD students compared with non-NAFLD ones. Such tendencies were observed independently of the presence of obesity. Additionally, one obese student with severe steatosis and liver dysfunction was diagnosed as having nonalcoholic steatohepatitis (NASH).

Conclusions

Approximately 4% of junior high school students had NAFLD that was primarily associated with obesity and reduced daily physical activity. Serum ALT measurement during school check-ups is recommended for the early detection of young adolescent NAFLD/NASH.

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Acknowledgments

We thank our nursing, nutrition, and laboratory staff for their skilled work, Mr. Hirotoshi Rokuhara for preparing the US instruments, and Mr. Trevor Ralph for his editorial assistance.

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Authors and Affiliations

  1. Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan

    Goro Tsuruta & Yoshiko Nakayama

  2. Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan

    Naoki Tanaka & Toshifumi Aoyama

  3. Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan

    Naoki Tanaka, Michiharu Komatsu, Takeji Umemura, Tetsuya Ichijo, Akihiro Matsumoto, Kaname Yoshizawa & Eiji Tanaka

  4. Shinshu University School of Health Science, Matsumoto, Japan

    Minoru Hongo

  5. Department of Gastroenterology, Showa Inan General Hospital, Komagane, Japan

    Akira Horiuchi & Yoshiko Nakayama

  6. Department of Laboratory Medicine, Showa Inan General Hospital, Komagane, Japan

    Kaeko Hamamoto & Chieko Iguchi

Authors
  1. Goro Tsuruta
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  2. Naoki Tanaka
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  3. Minoru Hongo
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  4. Michiharu Komatsu
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  5. Akira Horiuchi
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  7. Chieko Iguchi
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  8. Yoshiko Nakayama
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  9. Takeji Umemura
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  10. Tetsuya Ichijo
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  11. Akihiro Matsumoto
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  12. Kaname Yoshizawa
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  13. Toshifumi Aoyama
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  14. Eiji Tanaka
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Corresponding author

Correspondence to Naoki Tanaka.

Additional information

G. Tsuruta and N. Tanaka contributed equally to this work.

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Tsuruta, G., Tanaka, N., Hongo, M. et al. Nonalcoholic fatty liver disease in Japanese junior high school students: its prevalence and relationship to lifestyle habits. J Gastroenterol 45, 666–672 (2010). https://doi.org/10.1007/s00535-009-0198-4

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  • DOI: https://doi.org/10.1007/s00535-009-0198-4

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