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Predictors of non-alcoholic fatty liver disease (NAFLD) among children with obesity

  • Rashdan Zaki Mohamed , Muhammad Yazid Jalaludin and Azriyanti Anuar Zaini EMAIL logo
Published/Copyright: January 11, 2020
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 33 Issue 2

Abstract

Background

The prevalence of childhood obesity and its related comorbidities in Malaysia are alarming. Malaysia ranked second in childhood obesity among South-east Asian countries with a prevalence of 12.7%. This study was conducted to investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) among obese children and to ascertain the predictors associated with NAFLD.

Methods

NAFLD was diagnosed via ultrasonographic evidence of fatty liver in obese and overweight children who presented to the Paediatric Obesity Clinic of University Malaya Medical Centre (UMMC), Malaysia. Demographic, anthropometric, clinical and biochemical parameters were analysed and compared between the NAFLD and non-NAFLD groups. Statistical analyses were carried out.

Results

Twenty-one out of 33 obese and overweight children (63.6%) were found to have NAFLD. We found that 62% of our study population in the NAFLD group had metabolic syndrome based on the definition by the International Diabetes Federation (IDF). Mean body mass index (BMI), waist circumference (WC), triglyceride (TG) and alanine aminotransferase (ALT) were found to be significantly greater in the NAFLD group compared to the non-NAFLD group (35.2 [6.1] vs. 29.3 [4.7] kg/m2 [p-value 0.007]; 104.1 [11.4] vs. 94.1 [12] cm [p-value 0.034]; 1.5 [0.9] vs. 0.9 [0.3] mmol/L [p-value 0.002]; 60.7 [53.8] vs. 27.3 [13] U/L [p-value 0.007]). Multivariate regression analysis revealed TG as the independent predictor for NAFLD, with an odds ratio of 41.7 (95% confidence interval [CI] 0.001, 0.819) (p-value 0.04).

Conclusions

Prevalence of NAFLD among children who are obese and overweight is alarming with 62% having metabolic syndrome. TG was found to be a strong predictor for NAFLD.

Keywords: BMI; childhood obesity; non-alcoholic fatty liver disease (NAFLD); paediatric; ultrasonography
Corresponding author: Dr. Azriyanti Anuar Zaini, Department of Paediatrics, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia, Phone: +603-79593903, Fax: +603-79556114

Acknowledgements

We would like to thank Mr. Abid Nordin and his team from Nordin Kamil Consulting for their expert advice and professionalism.

  1. Author contributions: Rashdan Zaki Mohamed, Muhammad Yazid Jalaludin and Azriyanti Anuar Zaini designed the study. Rashdan Zaki Mohamed conducted the retrospective analysis and produced the initial draft of the manuscript. Muhammad Yazid Jalaludin and Azriyanti Anuar Zaini gave the final approval to the study design, results and manuscript. Azriyanti Anuar Zaini is the corresponding author for the manuscript.

  2. Research funding: The study was made possible with research funding by the University of Malaya.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing Interest: None declared.

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Received: 2019-08-29
Accepted: 2019-11-22
Published Online: 2020-01-11
Published in Print: 2020-02-25

©2020 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Air occlusion in insulin pumps of children and adolescents with type 1 diabetes
  4. Gastrointestinal symptoms in pediatric patients with type 1 diabetes mellitus
  5. Adherence to multiple medications in the TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) cohort: effect of additional medications on adherence to primary diabetes medication
  6. Ghrelin, obestatin and the ghrelin/obestatin ratio as potential mediators for food intake among obese children: a case control study
  7. Association between neck circumference and non-alcoholic fatty liver disease in Mexican children and adolescents with obesity
  8. Comparison between metabolically healthy obesity and metabolically unhealthy obesity by different definitions among Mexican children
  9. Evidence in obese children: contribution of tri-ponderal mass index or body mass index to dyslipidemia, obesity-inflammation, and insulin sensitivity
  10. Prevalence of metabolic syndrome and its associated factors in overweight and obese adolescents
  11. Cortisol secretion pattern in overweight/obese and normal-weight infants: a cross-sectional study
  12. Predictors of non-alcoholic fatty liver disease (NAFLD) among children with obesity
  13. Relative leptin deficiency in children with severe early-onset obesity (SEOO) – results of the Early-onset Obesity and Leptin – German-Polish Study (EOL-GPS)
  14. Novel associations of serum adropin and lipopolysaccharide-binding protein versus lipid profiles in childhood obesity
  15. The trade-off between the olfactory bulb and eyeball volume in precocious puberty
  16. Gender-based differences in the clustering of metabolic syndrome factors in children and adolescents
  17. Presentation of 14 alkaptonuria patients from Turkey
  18. Assessment of health-related quality of life in Egyptian children and adolescents with congenital adrenal hyperplasia
  19. Case Reports
  20. Familial hypophosphatemic rickets caused by a PHEX gene mutation accompanied by a NPR2 missense mutation
  21. Cinacalcet treatment experience in hereditary vitamin D resistant rickets
  22. Can we effectively predict the occurrence of cerebral edema in children with ketoacidosis in the course of type 1 diabetes? – case report and literature review
https://doi.org/10.1515/jpem-2019-0403
Keywords for this article
BMI; childhood obesity; non-alcoholic fatty liver disease (NAFLD); paediatric; ultrasonography

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Air occlusion in insulin pumps of children and adolescents with type 1 diabetes
  4. Gastrointestinal symptoms in pediatric patients with type 1 diabetes mellitus
  5. Adherence to multiple medications in the TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) cohort: effect of additional medications on adherence to primary diabetes medication
  6. Ghrelin, obestatin and the ghrelin/obestatin ratio as potential mediators for food intake among obese children: a case control study
  7. Association between neck circumference and non-alcoholic fatty liver disease in Mexican children and adolescents with obesity
  8. Comparison between metabolically healthy obesity and metabolically unhealthy obesity by different definitions among Mexican children
  9. Evidence in obese children: contribution of tri-ponderal mass index or body mass index to dyslipidemia, obesity-inflammation, and insulin sensitivity
  10. Prevalence of metabolic syndrome and its associated factors in overweight and obese adolescents
  11. Cortisol secretion pattern in overweight/obese and normal-weight infants: a cross-sectional study
  12. Predictors of non-alcoholic fatty liver disease (NAFLD) among children with obesity
  13. Relative leptin deficiency in children with severe early-onset obesity (SEOO) – results of the Early-onset Obesity and Leptin – German-Polish Study (EOL-GPS)
  14. Novel associations of serum adropin and lipopolysaccharide-binding protein versus lipid profiles in childhood obesity
  15. The trade-off between the olfactory bulb and eyeball volume in precocious puberty
  16. Gender-based differences in the clustering of metabolic syndrome factors in children and adolescents
  17. Presentation of 14 alkaptonuria patients from Turkey
  18. Assessment of health-related quality of life in Egyptian children and adolescents with congenital adrenal hyperplasia
  19. Case Reports
  20. Familial hypophosphatemic rickets caused by a PHEX gene mutation accompanied by a NPR2 missense mutation
  21. Cinacalcet treatment experience in hereditary vitamin D resistant rickets
  22. Can we effectively predict the occurrence of cerebral edema in children with ketoacidosis in the course of type 1 diabetes? – case report and literature review
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