Childhood adiposity trajectories and risk of nonalcoholic fatty liver disease in adolescents

Abstract

Background and Aim Nonalcoholic fatty liver disease (NAFLD) and its metabolic risk factors are recognized during childhood and adolescence. Identification of adolescents at risk of NAFLD from childhood anthropometry may expose opportunities to influence the hepatic and metabolic destinies of individuals. We sought associations between NAFLD diagnosed during adolescence and earlier life trajectories of anthropometry, in a population‐based cohort of predominantly Caucasian adolescents. Methods Assessment for NAFLD, using questionnaires and liver ultrasound, was performed on 1170 adolescents, aged 17 years, from the population‐based Raine cohort. We sought associations between NAFLD in adolescents and serial anthropometric measurements recorded from birth, childhood, and adolescence. Results NAFLD was diagnosed in 15.2% of adolescents. Birth anthropometry, including birth weight, skinfold thickness, and ponderal index, was not associated with NAFLD. However, adiposity differences between 17‐year‐old adolescents with NAFLD and those without NAFLD were apparent from age 3 years. Greater adiposity trajectories for weight, body mass index, skinfold thickness, mid‐arm circumference, and chest circumference from age 3 years onwards, particularly in males, were associated with the diagnosis of NAFLD and severity of hepatic steatosis at age 17 years (P < 0.05). The strength of the associations increased with age after 3 years for each adiposity measure (all P < 0.001). Conclusions Trajectories of childhood adiposity are associated with NAFLD. Adiposity attained by 3 years of age and older, but not at birth, was associated with the diagnosis and severity of hepatic steatosis in late adolescence. Exploration of clinically relevant risk factors and preventative measures for NAFLD should begin during childhood.

Burden of non‐alcoholic fatty liver disease in Australia

“…Among 1170 individuals who underwent ultrasound at age 17, NAFLD was found in 13% and was more common in girls than boys (16% vs 10%); however, this was related to more female individuals being centrally obese . Children with excess weight at age 3 were more likely to have NAFLD in teenage years …”

Nonalcoholic fatty liver disease in adolescents and young adults: The next frontier in the epidemic

“…Furthermore, 4%‐6% of all youth in the United States have severe obesity and gain weight faster than any other subgroup . The importance of these facts is highlighted by studies that demonstrated that obese adolescents are more likely to develop severe obesity by the time they reach their early thirties; childhood adiposity is associated with NAFLD in adolescence; and weight gain in childhood correlates with the entire histological and clinical spectrum of adult NAFLD regardless of initial or attained BMI . A recent large cohort study demonstrated that overweight adolescents (aged 18‐20 years) have an increased risk of severe liver disease (hazard ratio, 1.64; 95% confidence interval [CI], 1.16‐2.32; P = 0.006) compared to those with normal BMI after a follow‐up of 39 years .…”

Cord Blood Adipokines and Lipids and Adolescent Nonalcoholic Fatty Liver Disease

“…Increasing maternal body mass index (BMI) has also been associated with increased neonatal liver fat deposition (10). Long-term human studies are, however, less consistent with birth weight positively associated with adverse liver function or a diagnosis of NAFLD at age 17 years in some (11) but not all studies (12). …”