Prevalence and Correlates of Suspected Nonalcoholic Fatty Liver Disease in Chinese Children

Abstract

Nonalcoholic fatty liver disease (NAFLD) has become a serious public health problem worldwide; however, the availability of information on the prevalence of NAFLD in the general pediatric population is still limited. The primary aim of this study was to reveal the prevalence and correlates of suspected NAFLD in Chinese children at the national level. Data from the China Health and Nutrition Surveys (CHNS) was used. Weight, height, waist circumference (WC), blood pressure (BP) were measured for children aged 7–18 years. Blood samples were collected and analyzed. Children were classified as having suspected NAFLD if common causes of liver disease were excluded, and serum alanine aminotransferase (ALT) values were above the established thresholds (>22.1 IU/L for girls and >25.8 IU/L for boys). A percentage of 9.03% (75 out of 831) of Chinese children was found to have suspected NAFLD. Overweight and obesity according to BMI percentiles, abdominal obesity, hyperuricemia (uric acid (UA) > 327 μmol/L), and elevated total cholesterol (TC) were all detected as the correlates of childhood suspected NAFLD when adjusting for other factors. Our study revealed the prevalence of suspected NAFLD in general Chinese children at the national level for the first time. Our findings indicate that suspected NAFLD in children is associated with increasing childhood morbidities, further studies are needed to better understand the prevalence of childhood NAFLD and its correlates, and large-scale programs should be launched to screen NAFLD in the pediatric population in China.

Lipid profile pattern in pediatric overweight population with or without NAFLD in relation to IDF criteria for metabolic syndrome: a preliminary study

“…In children, hyperuricemia and NAFLD are usually associated in obese children partly due to increased fructose intake [13,16]. Also, one recent populational Chinese study revealed that abdominal obesity, BMI percentiles and hyperuricemia are associated with suspected NAFLD after adjusting for other confounders [17].…”

Association between remnant lipoprotein cholesterol levels and non-alcoholic fatty liver disease in adolescents

“…[2][3][4][5][6] Previous studies reported population prevalence ranges of 3-18% in adolescents and a global prevalence of up to 25% in adults, increasing to >90% in very obese adults and 38% in obese children. [5][6][7][8][9][10][11] Sex differences in the prevalence and phenotype of NAFLD associated with adiposity distribution have also been reported. 5 The global burden of NAFLD has progressively increased over recent decades, likely as a result of an increased prevalence of obesity, T2DM, dyslipidaemia and hypertension, which are concurrent risk factors for cardiovascular disease (CVD).…”

High Protein Diet and Metabolic Plasticity in Non-Alcoholic Fatty Liver Disease: Myths and Truths

“…In obese children, the reported NAFLD prevalence is 38%, it is expected to become the main cause for liver failure. This is the first indication for a surge in liver transplants in childhood and adolescence in the near future [6][7][8][9][10][11].…”