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research letter

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.
Email: kanupriyachaturvedi@gmail.com

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 [1]. 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 [2]. 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 [3]. 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 [4] but lower than that reported from Turkey [5]. 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. 2005;47:23-7.


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