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Prevalence of nonalcoholic fatty liver disease in normal-weight and overweight preadolescent children in Haryana, India

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Abstract

Objective

To document the prevalence of non-alcoholic fatty liver disease (NAFLD) and metabolic parameters among normalweight and overweight schoolchildren.

Design

Cross-sectional study.

Setting

Thirteen private schools in urban Faridabad, Haryana.

Participants

961 school children aged 5-10 years.

Methods

Ultrasound testing was done, and 215 with fatty liver on ultrasound underwent further clinical, biochemical and virological testing.

Outcome measures

Prevalence of fatty liver on ultrasound, and NAFLD and its association with biochemical abnormalities and demographic risk factors.

Results

On ultrasound, 215 (22.4%) children had fatty liver; 18.9% in normal-weight and 45.6% in overweight category. Presence and severity of fatty liver disease increased with body mass index (BMI) and age. Among the children with NAFLD, elevated SGOT and SGPT was observed in 21.5% and 10.4% children, respectively. Liver enzyme derangement was significantly higher in overweight children (27% vs 19.4% in normal-weight) and severity of fatty liver (28% vs 20% in mild fatty liver cases). Eleven (8.1%) children with NAFLD had metabolic syndrome. Higher BMI (OR 35.9), severe fatty liver disease (OR 1.7) and female sex (OR 1.9) had strong association with metabolic syndrome.

Conclusions

22.4% of normal-weight and overweight children aged 5-10 years had fatty liver. A high proportion (18.9%) of normal-weight children with fatty liver on ultrasound indicates the silent burden in the population.

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References

  1. Bellentani S, Marino M. Epidemiology and natural history of non-alcoholic fatty liver disease (NAFLD). Ann Hepatol. 2009;8:S4–S8.

    PubMed  Google Scholar 

  2. Schwimmer JB, Deutsch R, Kahen T, Lavine JE, Stanley C, Behling C. Prevalence of fatty liver in children and adolescents. Pediatrics. 2006;118:1388–93.

    Article  PubMed  Google Scholar 

  3. Wieckowska A, Feldstein AE. Diagnosis of nonalcoholic fatty liver disease: invasive versus non-invasive. Semin Liver Dis. 2008;28:386–95.

    Article  CAS  PubMed  Google Scholar 

  4. Amarapurkar D N, Hashimoto E, Lesmana LA, SoIlano JD, Chen PJ, Goh KL, Asia-Pacific Working Party on NAFLD. How common is non-alcoholic fatty liver disease in the Asia-Pacific region and are there local differences? J Gastroenterol Hepatol. 2007;22:788–93.

    Article  PubMed  Google Scholar 

  5. Duseja A. Nonalcoholic fatty liver disease in India-a lot done, yet more required! Indian J Gastroenterol. 2010;29:217–25.

    Article  PubMed  Google Scholar 

  6. Bajaj S, Nigam P, Luthra A, Pandey RM, Kondal D, Bhatt SP, et al. A case-control study on insulin resistance, metabolic co-variates & prediction score in non-alcoholic fatty liver disease. Indian J Med Res. 2009;129:285–92.

    CAS  PubMed  Google Scholar 

  7. Jou J, Choi SS, Diehl AM. Mechanisms of disease progression in nonalcoholic fatty liver disease. Semin Liver Dis. 2008;28:370–9.

    Article  CAS  PubMed  Google Scholar 

  8. Hesham AK. Nonalcoholic fatty liver disease in children living in the obeseogenic society. World J Pediatr. 2009;5:245–54.

    Article  Google Scholar 

  9. Widhalm K, Ghods E, Nonalcoholic fatty liver diseases: a challenge for pediatricians. Int J Obes (Lond). 2010;34:1451–67.

    Article  CAS  Google Scholar 

  10. Anderson EL, Howe LD, Jones HE, Higgins JPT, Lawlor DA, Fraser A. The prevalence of non-alcoholic fatty liver disease in children and adolescents: a systematic review and meta-analysis. PLoSONE. 2015;10:e0140908.

    Article  Google Scholar 

  11. Kelishadi R, Cook SR, Adibi A, Faghihimani Z, Ghatrehsamani S, Beihaghi A, et al. Association of the components of the metabolic syndrome with non-alcoholic fatty liver disease among normal-weight, overweight and obese children and adolescents. Diabetol Metab Syndr. 2009;1:29.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Fu JF, Shi HB, Liu LR, Jiang P, Liang L, Wang CL. Nonalcoholic fatty liver disease: An early mediator predicting metabolic syndrome in obese children? World J Gastroenterol. 2011;17:735–42.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Cole TJ, Flegal KM, Nicholls D and Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007;335:194.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Needleman L, Kurtz AB, Rifkin MD, Cooper HS, Pasto ME, Goldberg BB. Sonography of diffuse benign liver disease: accuracy of pattern recognition and grading. Am J Roentgenol. 1986;146:1011–5.

    Article  CAS  Google Scholar 

  16. McCarthy HD, Jarrett KV, Crawley HF. The development of waist circumference percentile in British children aged 5.0-16.9 y. Eur J Clin Nutr. 2001;55:902–7.

    Article  CAS  PubMed  Google Scholar 

  17. Raj M, Sundaram KR, Paul M, Deepa AS, Kumar RK. Obesity in Indian children: time trends and relationship with hypertension. Natl Med J India. 2007;20:288–93

    PubMed  Google Scholar 

  18. Ferreria AP, Oliveria CER, Franca NM. Metabolic syndrome and risk factors for cardiovascular disease in obese children; the relationship with insulin resistance (HOMA-IR). J Pediatr. 2007;83:21–6.

    Article  Google Scholar 

  19. Irshad, Zargar SA, Khan BA, Ahmad B, Saif RU, Kawoosa A, et al. Ultrasonographic prevalence of non–alcoholic fatty liver disease (NAFLD) in Kashmir valley school children. Int J Sci Res. 2013;2:299–301.

    Google Scholar 

  20. Chaturvedi K and Vohra P. Non-alcoholic fatty liver disease in children. Indian Pediatr. 2012;49:757–8.

    Article  PubMed  Google Scholar 

  21. Pawar SV, Zanwar VG, Choksey AS, Mohite AR, Jain SS, Surude RG, et al. Most overweight and obese Indian children have nonalcoholic fatty liver disease. Ann Hepatol. 2016;15:853–61.

    PubMed  Google Scholar 

  22. Jun-Fen Fu, Hong-Bo Shi, Li-Rui Liu, Ping Jiang, Li Liang, Chun-Lin Wang, et al. Non-alcoholic fatty liver disease: An early mediator predicting metabolic syndrome in obese children? World J Gastroenterol. 2011;17:735–42.

    Article  Google Scholar 

  23. Tominaga K, Fujimoto E, Suzuki K, Hayashi M, Ichikawa M, Inaba Y. Prevalence of non alcoholic fatty liver disease in children and relationship to metabolic syndrome, insulin resistance and waist circumference. Environ Health Prev Med. 2009;14:142–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Patton HM, Yates K, Arida AU, Behling CA, Huang TTK, Rosenthal P, et al. Association between metabolic syndrome and liver histology among children with nonalcoholic fatty liver disease. Am J Gastroenterol. 2010;105:2093–102.

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. The INCLEN Trust International, F1/5, Okhla Industrial Area, Phase I, New Delhi, India

    Manoja Kumar Das & Narendra K Arora

  2. Department of Pediatric Gastroenterology and Hepatology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India

    Vidyut Bhatia, Anupam Sibal, Sarath Gopalan & Ankur Roy

  3. Department of Biochemistry, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India

    Abha Gupta

  4. Department of Microbiology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India

    Raman Sardana

  5. Department of Radiodiagnosis, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India

    Reeti Sahni

Authors
  1. Manoja Kumar Das
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  2. Vidyut Bhatia
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  3. Anupam Sibal
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  4. Abha Gupta
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  5. Sarath Gopalan
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  6. Raman Sardana
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  7. Reeti Sahni
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  8. Ankur Roy
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  9. Narendra K Arora
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Corresponding author

Correspondence to Manoja Kumar Das.

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Das, M.K., Bhatia, V., Sibal, A. et al. Prevalence of nonalcoholic fatty liver disease in normal-weight and overweight preadolescent children in Haryana, India. Indian Pediatr 54, 1012–1016 (2017). https://doi.org/10.1007/s13312-017-1202-3

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  • DOI: https://doi.org/10.1007/s13312-017-1202-3

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