Abstract

To investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) in children and its relationship to metabolic syndrome, insulin resistance, and waist circumference (WC). This was a population-based cross-sectional, case-control study. Cases were selected among students of a primary and junior high school, respectively, and age- and sex-matched control subjects were selected randomly (ratio of cases to control subject was 37:113). Of the 846 students, aged between 6 and 15 years, enrolled in the study and screened by ultrasonography, 37 children were diagnosed as having NAFLD (score >/= 1). There was a significant sex difference in the prevalence of NAFLD(P = 0.003). The trend test revealed a strong dose-response relationship (P < 0.001) between pediatric NAFLD and the number of the proposed components of pediatric metabolic syndrome in Japan (MetS-JC), such as a clustering of the components of MetS-JC. Additionally, the linear trend of the odds ratios (ORs) with increasing percentile of the homeostasis model assessment-insulin resistance (HOMA-IR) was statistically significant (P < 0.001). However, when WC was added to the logistic model, the ORs were no longer significant, whereas WC turned out to be an independent risk factor for NAFLD regardless of the HOMA-IR index. The prevalence of NAFLD in children and adolescents is closely related to metabolic syndrome, insulin resistance, and WC.

Highlights

  • 37 children were diagnosed as having non-alcoholic fatty liver disease (NAFLD)

  • We found a correlation between waist circumference (WC) and the homeostasis model assessmentinsulin resistance (HOMA-IR) index of r = 0.467 (P \ 0.001), which indicates that both variables can be placed together in the logistic models

  • We showed that the odds ratios (ORs) for NAFLD increased with increasing percentile of HOMA-IR index following an adjustment for age and sex

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Summary

Objectives

To investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) in children and its relationship to metabolic syndrome, insulin resistance, and waist circumference (WC). Methods This was a population-based cross-sectional, case–control study. Cases were selected among students of a primary and junior high school, respectively, and ageand sex-matched control subjects were selected randomly (ratio of cases to control subject was 37:113). Results Of the 846 students, aged between 6 and 15 years, enrolled in the study and screened by ultrasonography, K. Inaba Department of Epidemiology and Environmental Health, Juntendo University School of Medicine, Juntendo University, Tokyo, Japan

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