Nonalcoholic Fatty Liver Disease in Young Children with Obesity

Corie Klepper; Nancy A. Crimmins; Sarah Orkin; Qin Sun; Lin Fei; Stavra Xanthakos; Marialena Mouzaki

doi:10.1089/chi.2022.0048

Nonalcoholic Fatty Liver Disease in Young Children with Obesity

Corie Klepper, Nancy A. Crimmins, Sarah Orkin, Qin Sun, Lin Fei, Stavra Xanthakos, Marialena Mouzaki^*

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background: To evaluate the prevalence of suspected nonalcoholic fatty liver disease (NAFLD) in young children with obesity and determine associated risk factors. Methods: Retrospective single-center study of children with obesity, ages 2-6 years. Suspected NAFLD was defined as an alanine aminotransferase (ALT) >30 U/L. Multivariable analyses were performed to determine predictors of elevated ALT. Results: Among 237 children 2-6 years old, 35% had elevated ALT. Multivariable analysis showed that higher BMI z score [odds ratio (OR): 1.5 confidence interval (95% CI: 1.04-1.92)] and higher gamma-glutamyl transferase (GGT) [OR: 21.3 (95% CI: 3.7-121.1)] predicted elevated ALT. Of those with ≥2 ALT levels, 38% (n = 33/86) had a persistently elevated ALT (median ALT >30 U/L). Only 7% of patients with ALT >30 U/L underwent further testing to evaluate for alternative causes of liver disease. Conclusion: Suspected NAFLD is common in young children with obesity and predicted by obesity severity and GGT. Other cardiometabolic markers were equivalent between those with normal vs. elevated ALT, suggesting NAFLD onset may precede development of comorbidities. Earlier screening will enable prompt diagnosis and intervention, which may prevent or delay the onset of cardiometabolic diseases commonly associated with NAFLD in adolescence and adulthood.

Original language	English (US)
Pages (from-to)	179-185
Number of pages	7
Journal	Childhood Obesity
Volume	19
Issue number	3
DOIs	https://doi.org/10.1089/chi.2022.0048
State	Published - Apr 1 2023

Funding

This work was supported by NIH grant P30 DK078392 (Clinical Component) of the Digestive Diseases Research Core Center in Cincinnati. The funding agency had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the article; or the decision to submit the article for publication.

Keywords

NAFLD
cardiometabolic
obesity
preschool
youth

ASJC Scopus subject areas

Nutrition and Dietetics
Pediatrics, Perinatology, and Child Health
Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1089/chi.2022.0048

Cite this

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title = "Nonalcoholic Fatty Liver Disease in Young Children with Obesity",

abstract = "Background: To evaluate the prevalence of suspected nonalcoholic fatty liver disease (NAFLD) in young children with obesity and determine associated risk factors. Methods: Retrospective single-center study of children with obesity, ages 2-6 years. Suspected NAFLD was defined as an alanine aminotransferase (ALT) >30 U/L. Multivariable analyses were performed to determine predictors of elevated ALT. Results: Among 237 children 2-6 years old, 35% had elevated ALT. Multivariable analysis showed that higher BMI z score [odds ratio (OR): 1.5 confidence interval (95% CI: 1.04-1.92)] and higher gamma-glutamyl transferase (GGT) [OR: 21.3 (95% CI: 3.7-121.1)] predicted elevated ALT. Of those with ≥2 ALT levels, 38% (n = 33/86) had a persistently elevated ALT (median ALT >30 U/L). Only 7% of patients with ALT >30 U/L underwent further testing to evaluate for alternative causes of liver disease. Conclusion: Suspected NAFLD is common in young children with obesity and predicted by obesity severity and GGT. Other cardiometabolic markers were equivalent between those with normal vs. elevated ALT, suggesting NAFLD onset may precede development of comorbidities. Earlier screening will enable prompt diagnosis and intervention, which may prevent or delay the onset of cardiometabolic diseases commonly associated with NAFLD in adolescence and adulthood.",

keywords = "NAFLD, cardiometabolic, obesity, preschool, youth",

author = "Corie Klepper and Crimmins, {Nancy A.} and Sarah Orkin and Qin Sun and Lin Fei and Stavra Xanthakos and Marialena Mouzaki",

note = "Funding Information: This work was supported by NIH grant P30 DK078392 (Clinical Component) of the Digestive Diseases Research Core Center in Cincinnati. The funding agency had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the article; or the decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2023 Mary Ann Liebert, Inc.",

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doi = "10.1089/chi.2022.0048",

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AU - Klepper, Corie

AU - Crimmins, Nancy A.

AU - Orkin, Sarah

AU - Sun, Qin

AU - Fei, Lin

AU - Xanthakos, Stavra

AU - Mouzaki, Marialena

N1 - Funding Information: This work was supported by NIH grant P30 DK078392 (Clinical Component) of the Digestive Diseases Research Core Center in Cincinnati. The funding agency had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the article; or the decision to submit the article for publication. Publisher Copyright: © 2023 Mary Ann Liebert, Inc.

PY - 2023/4/1

Y1 - 2023/4/1

N2 - Background: To evaluate the prevalence of suspected nonalcoholic fatty liver disease (NAFLD) in young children with obesity and determine associated risk factors. Methods: Retrospective single-center study of children with obesity, ages 2-6 years. Suspected NAFLD was defined as an alanine aminotransferase (ALT) >30 U/L. Multivariable analyses were performed to determine predictors of elevated ALT. Results: Among 237 children 2-6 years old, 35% had elevated ALT. Multivariable analysis showed that higher BMI z score [odds ratio (OR): 1.5 confidence interval (95% CI: 1.04-1.92)] and higher gamma-glutamyl transferase (GGT) [OR: 21.3 (95% CI: 3.7-121.1)] predicted elevated ALT. Of those with ≥2 ALT levels, 38% (n = 33/86) had a persistently elevated ALT (median ALT >30 U/L). Only 7% of patients with ALT >30 U/L underwent further testing to evaluate for alternative causes of liver disease. Conclusion: Suspected NAFLD is common in young children with obesity and predicted by obesity severity and GGT. Other cardiometabolic markers were equivalent between those with normal vs. elevated ALT, suggesting NAFLD onset may precede development of comorbidities. Earlier screening will enable prompt diagnosis and intervention, which may prevent or delay the onset of cardiometabolic diseases commonly associated with NAFLD in adolescence and adulthood.

AB - Background: To evaluate the prevalence of suspected nonalcoholic fatty liver disease (NAFLD) in young children with obesity and determine associated risk factors. Methods: Retrospective single-center study of children with obesity, ages 2-6 years. Suspected NAFLD was defined as an alanine aminotransferase (ALT) >30 U/L. Multivariable analyses were performed to determine predictors of elevated ALT. Results: Among 237 children 2-6 years old, 35% had elevated ALT. Multivariable analysis showed that higher BMI z score [odds ratio (OR): 1.5 confidence interval (95% CI: 1.04-1.92)] and higher gamma-glutamyl transferase (GGT) [OR: 21.3 (95% CI: 3.7-121.1)] predicted elevated ALT. Of those with ≥2 ALT levels, 38% (n = 33/86) had a persistently elevated ALT (median ALT >30 U/L). Only 7% of patients with ALT >30 U/L underwent further testing to evaluate for alternative causes of liver disease. Conclusion: Suspected NAFLD is common in young children with obesity and predicted by obesity severity and GGT. Other cardiometabolic markers were equivalent between those with normal vs. elevated ALT, suggesting NAFLD onset may precede development of comorbidities. Earlier screening will enable prompt diagnosis and intervention, which may prevent or delay the onset of cardiometabolic diseases commonly associated with NAFLD in adolescence and adulthood.

KW - NAFLD

KW - cardiometabolic

KW - obesity

KW - preschool

KW - youth

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ER -

Nonalcoholic Fatty Liver Disease in Young Children with Obesity

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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