Prevalence of incidental sonographic findings of hepatic steatosis in children under 4years of age.

Abstract

The age of onset of nonalcoholic fatty liver disease (NAFLD) and its prevalence in young children is incompletely understood. We sought to evaluate the prevalence ofultrasound findings of hepatic steatosis in a cohort of children less than 4years of age. This is an institutional review board-approved retrospective review of ultrasounds performed on children less than 4years of age from January 2022 to August 2022 at a single quaternary care center.Two independent blinded reviewers evaluated for qualitative and semi-quantitative findings of hepatic steatosis. Per prior literature, hepatorenal index (HRI)>1.75 was used as a threshold suggestive of hepatic steatosis. Chi-square, Mann-Whitney U test, and logistic regression analyses were performed for univariable and multivariable statistical analyses. Kappa statistics were used to assess agreement between reviewers. Eighty-five males and 102 females, median age of 1.1years (interquartile range 2.1years), were included. Qualitative findings of hepatic steatosis were seen in 26/187 (14%; 95% CI 10-20%). An HRI>1.75 was present in 15/187 (8%; 95% CI: 5-13%) of examinations, including 11 females and 4 males, and 7/123 (6%) participants <2years old. Among participants with overweight or obesity, 8/43 (19%) had HRI>1.75 vs. 7/144 (5%) participants without overweight or obesity(P=0.004). Each percentile increase in anthropometrics percentile (weight-to-length or BMI, depending on age) was associated with 22 increased odds of HRI>1.75 (P=0.02). Prevalence of sonographic findings of hepatic steatosisin an unselected sample of preschool-age children is 8-14%, and aremore common in participants with overweight/obesity.