Friday, May 25, 2012

DDW- Fatty Liver Disease on Rise in Teens

Medpage Today DDW Coverage

Fatty Liver Disease on Rise in Teens
Action Points
+This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
+Data from the National Health and Nutrition Examination Survey (NHANES) from 1988 to 2008 showed an increase in non-alcoholic fatty liver disease among adolescents.
+Note that elevated serum ALT increased substantially in obese children over this time frame

SAN DIEGO -- The prevalence of non-alcoholic fatty liver disease (NAFLD) in adolescents has risen over the last few decades and now affects about one in 10 children, researchers said here.

From 1988 to 2008, the prevalence of NAFLD rose from 3.6% to 9.9% among children ages 12 to 18 (P<0.001), Miriam Vos, MD, of Emory University in Atlanta, and colleagues reported during a press briefing at Digestive Disease Week here.

Vos added that additional data from 2009 and 2010, however, have shown a potential flattening in that trend.

Still, she said, the data "point to the importance of continued study [of this condition in this population], particularly for prevention, because just like obesity, this disease is much easier to prevent than to treat."

NAFLD is the most common liver disease in children, and has been tied to further complications down the road, including diabetes, hypertension, and cancer.

Researchers have suspected that there's been an increase in the number of cases of NAFLD among pediatric patients in recent years, "but one of the challenges with that is, we're all looking for it more often because awareness has also been increased," Vos said.

So she and colleagues looked at data from the National Health and Nutrition Examination Survey (NHANES) 1988-2008 on 10,359 patients ages 12 to 18.

NAFLD was defined as being overweight or obese (having a body mass index [BMI] in the 85th percentile or higher) and having an elevated ALT (one that is above 25.8 for boys or above 22.1 for girls).

They found that the prevalence of NAFLD in this pediatric population rose significantly during the course of the study. Among overweight children, the prevalence of elevated ALT was 13.2% in 2008, with no significant increases over time, but in obese children, that prevalence jumped a significant 120% over the study period, from 16.7% to 36.9% (P=0.006).

Vos said the overall increase in pediatric NAFLD prevalence wasn't just determined by the prevalence of obesity or overweight in the sample. In fact, she said, NAFLD "seems to be increasing faster than the prevalence of obesity."

To understand why, they conducted further analyses and found that there's been an increase in average BMI in obese and overweight categories, and also in mean waist circumference in those categories.

"That seemed to nicely parallel the increase in NAFLD," she said. "That may be because an increase in belly fat or abdominal weight is very closely correlated with fatty liver disease."

Vos noted, however, that in additional data from 2009 and 2010, it seems that the trend may be flattening or even slightly improving. "It's not statistically significant, but I'm optimistic this is going to lead to good news in years to come," she said.

Nonetheless, she and colleagues concluded that the data strongly support recommendations to screen for NAFLD in obese adolescents.

The researchers reported no conflicts of interest.

Primary source: Digestive Disease Week
Source reference:
Vos MB, Welsh J "Prevalence of suspected NAFLD is increasing among U.S. adolescents" DDW 2012; Abstract 705.

Staff Writer

Kristina Fiore joined MedPage Today after earning a degree in science, health, and environmental reporting from NYU. She’s had bylines in newspapers and trade and consumer magazines including Newsday, ABC News, New Jersey Monthly, and Earth Magazine. At MedPage Today, she reports with a focus on diabetes, nutrition, and addiction medicine.

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