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

PLoS ONE, 2015

813 citations recorded by the source corpus.

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.

Subfields: Endocrinology, Diabetes and Metabolism, Epidemiology, Pathology and Forensic Medicine

View Paper: https://www.semanticscholar.org/paper/01b370baf1d07179e619345e421e1b68ade68eff

Citations in the corpus

• Epidemiology of metabolic dysfunction-associated steatotic liver disease (2024, background): “[44,45] However, the data is relatively old suggesting the prevalence of MASLD among children is close to 15-20%.”
• Contemporary Epidemiology of Chronic Liver Disease and Cirrhosis (2019, neutral): “Yellow (40-50), Yellow-Orange (50-60), Orange-Red (60-70), Red (>70) Moon et al. Page 21 Clin Gastroenterol Hepatol.”
• Metabolism Disrupting Chemicals and Metabolic Disorders (2016, neutral): “While there is an association between NAFLD and hyperlipidemia, not all patients with one disorder are affected by the other.”
• Sex Differences in Nonalcoholic Fatty Liver Disease: State of the Art and Identification of Research Gaps (2019, background): “In pediatric populations, a meta-analytic study showed that the pooled NAFLD prevalence is higher in boys than in girls in general populations and obese clinical cohorts.(18) The study also revealed significant variance across the published reports, which is partly explained by the technique used to”
• The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases (2018, background): “2% in studies based on pediatric obesity clinics.((265)) This meta-analysis highlights the higher prevalence of NAFLD in boys relative to girls, with prevalence increasing incrementally with BMI z-score.”