Non-alcoholic fatty liver disease : an emerging problem with childhood obesity

Abstract

Amongst the more clinically serious consequences of the global epidemic in obesity in children is the emergence of non-alcoholic steato-hepatitis (NASH), alternatively known as non-alcoholic fatty liver disease (NAFLD). The incidence of elevated transaminases (ALT, AST) in diverse obese adolescent populations is close to 3%. In adults, approximately 30% of obese individuals with elevated transaminases have steatohepatitis and almost half of these individuals will have progressive liver disease. The corresponding incidence of fatty liver in children is unclear; Moran and coworkers first demonstrated the occurrence of severe hepatitis and fibrosis in three obese children with transaminasemia in 1983. This was followed by several other reports defining the incidence of severe fibrosis or cirrhosis in one-third of children undergoing liver biopsy for the same indication.