Indian Pediatr 2012;49: 757-758
Non-alcoholic Fatty Liver Disease in Children
Kanupriya Chaturvedi and Pankaj Vohra
From the Department of Pediatrics, Holy Family
Hospital, New Delhi, India.
A cross sectional study was
conducted in 100 children, aged 5 to 12 years, to find the
prevalence of non-alcoholic fatty liver dieases (NAFLD), at New
Delhi. Those with fatty liver on ultrasonography with no apparent
etiology, were labeled as NAFLD. Three (3%) children had evidence of
fatty liver on ultrasonography.
Key Words: Non alcoholic fatty liver
disease (NAFLD), Prevalence, Ultrasound.
Non-alcoholic fatty liver disease (NAFLD) is
characterized by hepatic fat accumulation (steatosis) with no
apparent etiology . The risk factors for NAFLD are obesity,
insulin resistance and genetics. In adults, 15-20% of obese and 2-3%
of lean individuals have steatohepatitis . We intended to find
out the prevalence of NAFLD in children visiting Holy Family
Hospital, New Delhi, between June 2007 to December 2008.
One hundred children aged 5 to 12 years were
included. Children with malnutrition, acute or chronic liver
disease, history of hepatotoxic drug intake and those receiving
total parenteral nutrition were excluded. All children underwent
anthropometry (height, weight, body mass index (BMI) and waist to
hip ratio) and an ultrasound of the abdomen. The diagnosis of fatty
liver was based on ultrasonographic findings of hepatorenal echo
contrast, bright liver, deep attenuation, and vessel blurring .
Further evaluation of these children included liver transaminases,
lipid profile, hepatitis B surface antigen, anti-Hepatitis C
antibodies, fasting blood sugar, serum ceruloplasmin, and urine for
reducing substances. The children with no apparent etiology were
labeled as having NAFLD.
The mean age was 7.02±2.93 years. A total of 8% (n=8)
were at risk for overweight (BMI 85th-94th
centile) and 11% were obese (BMI above 95th
centile). Three children (3%) were found to have NAFLD; one was
obese (girl) and other two (both boys) had normal BMI. None of them
had hepatomegaly. The obese boy also had raised trasaminases and
raied fasting blood sugar.
The present study had limitations of a small
sample size to estimate true prevalence, and absence of liver biopsy
confirmation of NAFLD. The prevalence was comparable to 2.6% found
in Japanese children  but lower than that reported from Turkey
. Larger population based studies need to be conducted tothe true
prevalence and associated risk factors of NAFLD in Indian children.
1. Brunt EM. Nonalcoholic steatohepatitis:
definition and pathology. Semin Liver Dis. 2000;21:3-16.
2. Chan DF, Li AM, Chu WC, Chan MH, Wong EM, Liu
EK, et al. Hepatic steatosis in children. Int J Obes Relat
Metab Disord. 2004;28:1257-63.
3. Roberts E. Nonalcoholic steatohepatitis in
children. Curr Gasroenterol Rep. 2003;5:253-9.
4. Marion A, Baker J, Dhawan A. Fatty liver
disease in children. BMJ. 2003;89:648-58.
5. Arsalan N, Buyukgebiz B, •zturk Y, Cakmaci H.
Fatty liver disease in obese children: prevalence and correlation
with anthropometric measurements and hyperlipidemia. Turk J Pediatr.