Dataset Information

The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis.

ABSTRACT:

Background & aims

Narrative reviews of paediatric NAFLD quote prevalences in the general population that range from 9% to 37%; however, no systematic review of the prevalence of NAFLD in children/adolescents has been conducted. We aimed to estimate prevalence of non-alcoholic fatty liver disease (NAFLD) in young people and to determine whether this varies by BMI category, gender, age, diagnostic method, geographical region and study sample size.

Methods

We conducted a systematic review and meta-analysis of all studies reporting a prevalence of NAFLD based on any diagnostic method in participants 1-19 years old, regardless of whether assessing NAFLD prevalence was the main aim of the study.

Results

The pooled mean prevalence of NAFLD in children from general population studies was 7.6% (95%CI: 5.5% to 10.3%) and 34.2% (95% CI: 27.8% to 41.2%) in studies based on child obesity clinics. In both populations there was marked heterogeneity between studies (I2 = 98%). There was evidence that prevalence was generally higher in males compared with females and increased incrementally with greater BMI. There was evidence for differences between regions in clinical population studies, with estimated prevalence being highest in Asia. There was no evidence that prevalence changed over time. Prevalence estimates in studies of children/adolescents attending obesity clinics and in obese children/adolescents from the general population were substantially lower when elevated alanine aminotransferase (ALT) was used to assess NAFLD compared with biopsies, ultrasound scan (USS) or magnetic resonance imaging (MRI).

Conclusions

Our review suggests the prevalence of NAFLD in young people is high, particularly in those who are obese and in males.

SUBMITTER: Anderson EL

PROVIDER: S-EPMC4626023 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis.

Anderson Emma L EL Howe Laura D LD Jones Hayley E HE Higgins Julian P T JP Lawlor Debbie A DA Fraser Abigail A

PloS one 20151029 10

<h4>Background & aims</h4>Narrative reviews of paediatric NAFLD quote prevalences in the general population that range from 9% to 37%; however, no systematic review of the prevalence of NAFLD in children/adolescents has been conducted. We aimed to estimate prevalence of non-alcoholic fatty liver disease (NAFLD) in young people and to determine whether this varies by BMI category, gender, age, diagnostic method, geographical region and study sample size.<h4>Methods</h4>We conducted a systematic r ...[more]

PMID: 26512983

Similar Datasets

Project description:ObjectivesThe negative effects of smoking on numerous cardiovascular and metabolic diseases have been widely acknowledged. However, the potential effect of smoking cessation is relatively unelucidated. The objective of this study is to explore whether the prevalence of non-alcoholic fatty liver disease (NAFLD) in former smokers differs from the prevalence in current smokers.DesignSystematic review and meta-analysis.Data sourcesFour databases, that is, PubMed, Web of Science, Journal@Ovid and Scopus were searched from inception to 31 January 2023.Eligibility criteriaPopulation-based cross-sectional studies, including the baseline data of cohort studies with identified NAFLD diagnostic methods, and smoking status (current smoker or former smoker) of participants were included.Data extraction and synthesisTwo reviewers independently extracted the data including cigarette smoking status, country/region of studies, NAFLD diagnostic methods, sex, the average age and body mass index (BMI) of NAFLD participants and assessed the risk of bias with Agency for Healthcare Research and Quality (AHRQ) methodology checklist. Risk ratio (RR) of NAFLD prevalence in former smokers was pooled using the random-effects model.Results28 studies involving 4 465 862 participants were included. Compared with current smokers, the RR of overall NAFLD prevalence in former smokers was 1.13 (95% CI: 1.08 to 1.19, prediction interval: 0.92-1.39). This result persisted after adjustment for diagnostic methods, country/region, sex, age and BMI. Sensitivity analysis and risk of bias assessment indicated a stable conclusion.ConclusionsNAFLD prevalence in former smokers was at least not lower than that in current smokers and was partially related to increased BMI after smoking cessation, indicating that smoking cessation was possibly not a protective factor against NAFLD. Although the meta-analysis based on cross-sectional studies cannot conclude the causal relationships between smoking cessation and NAFLD onset, the potential onset of NAFLD associated with smoking cessation should be highlighted.Prospero registration numberCRD42023394944.

Project description:Background The incidence of childhood obesity is increasing. There is some controversy about the association between overweight and nonalcoholic fatty liver disease (NAFLD) in children. This article intends to compare the differences in these obesity related parameters between NAFLD children and healthy control children through meta-analysis to provide evidence-based medical evidence for clinical use. Methods The literature were extracted from English and Chinese databases. Statistical analysis was performed using Stata/SE 16.0, IBM SPSS Statistics 26, and Review Manager 5.4 software. Results A total of 15 original case control studies were included, including 12 high-quality literature, 3 medium quality literature. The total sample size included in the analysis was 1,595 children, including 824 in the experimental group and 771 in the control group. The results of meta-analysis showed that the body mass index (BMI) of the NAFLD group was significantly higher than that of the control group [mean difference (MD) =1.05, 95% confidence interval (CI): 0.36–1.73]. Waist circumference of the NAFLD group was significantly larger than that of the control group (MD =1.66, 95% CI: 0.60–2.73). Triglyceride level in the NAFLD group was significantly higher than that in the control group (MD =1.08, 95% CI: 0.05–2.12). Low-density lipoprotein (LDL) level in the NAFLD group was significantly higher than that in the control group (MD =0.49, 95% CI: 0.12–0.85). In addition, fasting blood glucose of the NAFLD group was significantly higher than that of the control group (MD =0.31, 95% CI: 0.09–0.54) and insulin resistance index of the NAFLD group was significantly higher than that of the control group (MD =2.95, 95% CI: 1.41–4.49). Exercise had a significant effect on improving the degree of NAFLD in children [odds ratio (OR) =2.51, 95% CI: 1.83–3.43]. Conclusions Various physical indicators were related to obesity, including BMI, waist circumference, triglyceride content, LDL, fasting blood glucose, and insulin resistance index, and all were significantly correlated with NAFLD in children, provided a reference for future clinical diagnosis and treatment work. In addition, exercise could significantly improve the degree of steatosis in children with NAFLD.

Project description:Background & aimThere is currently no agreement on the screening strategy for non-alcoholic fatty liver disease (NAFLD) in children at risk. The North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) recommends screening for NAFLD using alanine aminotransferase (ALT) in obese/overweight children, while the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommends using both ALT and abdominal ultrasound. The aim of this study was to assess the prevalence of suspected NAFLD in obese children based on the 2 screening strategies.MethodConsecutive overweight/obese children seen at a weight-management program were included. Each child underwent a liver ultrasound and had ALT level measured at first visit. Two screening strategies were compared: the NASPGHAN strategy using ALT ≫2x the gender specific cut-off and the ESPGHAN strategy using elevated ALT ≫45 IU/L and/or fatty liver on ultrasound. Univariate and multivariate analyses were performed to assess predictors of low ALT in individuals with evidence of suspected NAFLD on ultrasound.ResultsOverweight/obese children were included. NAFLD was suspected as follows: 26% based on the NASPGHAN strategy, and 58% based on the ESPGHAN strategy. Fatty liver was present on ultrasound in 53% of our cohort. ALT was ≫2x the gender specific cut-off in only 26% of children with fatty liver on ultrasound. Univariate and multivariate analyses indicated that children with fatty infiltration on ultrasound and low ALT were less likely to have metabolic syndrome, insulin resistance, or hypertriglyceridemia.ConclusionBy relying on ALT values alone to screen for NAFLD, suspected NAFLD might be missed in many children who are at risk. Children with fatty infiltration on ultrasound and low ALT may be less likely to have metabolic syndrome, insulin resistance or hypertriglyceridemia.Lay summaryUsing the combination of elevated alanine aminotransferase and fatty infiltration on ultrasound increases the detection rate of suspected non-alcoholic fatty liver disease in at-risk children. Notably, a significant percentage of children with fatty infiltration on ultrasound have low alanine aminotransferase (≪52/44). Children with fatty infiltration on ultrasound and low alanine aminotransferase may be less likely to have features of the metabolic syndrome.

Project description:Background and aimNon-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in children. With the continuous emergence of various non-invasive diagnostic methods, imaging techniques have always been considered as potential alternative methods to liver biopsy. This study aimed to evaluate the diagnostic performance of imaging techniques so as to search for the most promising technology.MethodsWe searched English and Chinese databases. English databases included Cochran library, Embase, PubMed, and Web of Science, while Chinese databases included the Wanfang database and China National Knowledge Internet.ResultsFinally, 11 articles were included (12 studies, one of which included studies on both fibrosis and steatosis). Further, 26.2% of the participants had mild steatosis, 34.1% had moderate steatosis, and 34.9% had severe steatosis. Also, 64.0% had any fibrosis, 29.1% had significant fibrosis, 13.8% had advanced fibrosis, and 2.8% had cirrhosis. Irrespective of the grade of fibrosis, transient elastography (TE) had higher sensitivity (97-100%), whereas magnetic resonance elastography (MRE) had the lowest sensitivity (58-63%). The pooled sensitivity and specificity of imaging techniques in diagnosing steatosis were 89% (95% CI, 71-96) and 89% (95% CI, 72-96), and AUROC 0.95 (95% CI, 93-97), multifrequency magnetic resonance elastography-hepatic fat fraction (mMRE-HFF) had the highest sensitivity (87%, 95% CI 77-97), ultrasonography (US) had the lowest specificity (96%, 95% CI 92-98%).ConclusionImaging techniques have a good diagnostic performance for children with NAFLD, especially the diagnosis of liver fibrosis based on ultrasound or magnetic resonance elastography. Compared with different imaging techniques, TE has the best performance in diagnosing significant fibrosis. Liver stiffness measurement (LSM) is expected to become a biological indicator for routine screening, dynamic monitoring of disease changes, and prognostic evaluation.

Dataset Information

The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis.

Background & aims

Methods

Results

Conclusions

Publications

The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets