Early life programming of nonalcoholic fatty liver disease in children

Abstract

BackgroundResearch is beginning to implicate early life characteristics in the development of pediatric nonalcoholic fatty liver disease, however the relationship with perinatal characteristics is poorly understood. AimsWe evaluated the association between perinatal characteristics and nonalcoholic fatty liver disease in childhood. Study designNested case-control study. Subjects5104 children born in Quebec, Canada between 2006 and 2019. Exposures included maternal diabetes, obesity, prematurity, and other birth complications. Outcome measuresThe outcome was nonalcoholic fatty liver disease diagnosed in hospital before 14 years of age. We calculated adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between birth characteristics and nonalcoholic fatty liver disease. ResultsA total of 104 children with nonalcoholic fatty liver disease were included. Gestational diabetes (OR 2.17, 95% CI 1.15–4.10), preexisting diabetes (OR 5.75, 95% CI 2.67–12.4), and maternal obesity (OR 3.06, 95% CI 1.71–5.45) were associated with childhood nonalcoholic fatty liver disease. Prematurity (OR 1.93, 95% CI 1.06–3.54) and neonatal intensive care unit admission (OR 2.18, 95% CI 1.10–4.33) were also associated with nonalcoholic fatty liver disease. However, there was no association with low birthweight, small-for-gestational age birth, and macrosomia. ConclusionsMaternal metabolic disorders and prematurity may initiate processes early in life that lead to the development of nonalcoholic fatty liver disease in childhood.