275 Non-Alcoholic Fatty Liver Disease and Steatohepatitis in Taiwanese Children: The Prevalence and Serum Retinol Binding Protein 4 Level

Abstract

Subjective: The aims of this study were to investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) in schoolchildren with various body mass index (BMI). Moreover, the correlation between serum RBP4 level and liver injury was investigated. Methods: 847 schoolchildren aged 4 to 12 years were evaluated by anthropometric measurements. The serum glucose, aspartate aminotransferase (AST), alanine aminotransferase (ALT), triglycerides and cholesterol levels were measured after an 8-hour overnight fast. NAFLD was diagnosed as fatty infiltrates of liver in sonogram and NASH was defined as NAFLD with an elevated ALT level. Results: The prevalence of overweight (85th % 95th %) in schoolchildren was 14.8% and 11.4%, respectively. The mean age and male-to-female ratio were significantly higher in children with obesity than those with normal weight (P=0.001). The obese children had a higher rate of abnormal AST and ALT (P< 0.001) and higher fasting triglyceride (P< 0.001) and glucose (P=0.04) levels than those with normal weight. Among 245 children with ultrasound examinations, fatty liver disease was identified in 2.5%, 20.6%, and 68.2% of children with normal weight, overweight, and obesity, respectively. Nine (40.9%) subjects were diagnosed as NASH in children with obesity. The serum RBP4 level was significantly higher in children with NAFLD and NASH than that in normal (P< 0.05). Conclusions: Childhood obesity is closely related to male gender, increase of age, fasting triglycerides, and glucose levels. Moreover, the serum RBP4 level was parallel to the liver injury in children.