Hepatic steatosis and severity-related factors in obese children
Article first published online: 22 AUG 2013
© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 28, Issue 9, pages 1532–1538, September 2013
How to Cite
Navarro-Jarabo, J. M., Ubiña-Aznar, E., Tapia-Ceballos, L., Ortiz-Cuevas, C., Pérez-Aísa, M. A., Rivas-Ruiz, F., Andrade, R. J. and Perea-Milla, E. (2013), Hepatic steatosis and severity-related factors in obese children. Journal of Gastroenterology and Hepatology, 28: 1532–1538. doi: 10.1111/jgh.12276
- Issue published online: 22 AUG 2013
- Article first published online: 22 AUG 2013
- Accepted manuscript online: 22 MAY 2013 06:40AM EST
- Manuscript Accepted: 26 APR 2013
- aminotransferase levels;
- hepatic disease;
- non-alcoholic fatty liver disease;
- severity disease;
Background and Aim
Obesity is an important health-care problem in developed countries. It is considered a multisystemic disease, but it may also affect the liver, thus provoking non-alcoholic fatty liver disease. This disease has been less extensively studied among children than among adults. We propose to analyze the prevalence of hepatic steatosis among a pediatric population within an area in southern Europe besides the variables associated with its development and severity.
Cross-sectional study carried out on a population of children aged 6–14 years inclusive, using abdominal ultrasound as a method to determine the presence and severity of hepatic steatosis; in addition, anthropometric and blood-tested parameters were examined to determine which of these were associated with steatosis.
One hundred forty-four children were analyzed, 84 male (58.3%). Steatosis was detected in 50 children (34.7%; 95% confidence interval [CI]: 26.0–42.0%). In six of these cases (12%), elevated aminotransferase levels were recorded. Factors found to be associated with steatosis were body mass index ≥ 99th percentile (odds ratio [OR] 3.58, 95% CI 1.16–15.6) and the level of alanine aminotransferase (ALT) (OR 1.08, 95% CI 1.03–1.13), while its severity was associated with ALT (OR 1.17, 95% CI 1.09–1.28). A level of ALT < 23.5 UI/dL predicted lack of severe steatosis with an area under receiver operating characteristic curve of 0.805 (95% CI 0.683–0.927).
Non-alcoholic fatty liver disease is common in the obese pediatric population in our geographical area. High levels of ALT are associated with severe steatosis, although having ALT above the normal range is not common. Also, the lack of severity of steatosis can be predicted in a subgroup of children with obesity.