The change in prevalence of suspected non-alcoholic fatty liver disease in Korean adolescents from 2001 to 2017

Abstract

ABSTRACT Aim Data on trends in the prevalence of suspected non-alcoholic fatty liver disease (NAFLD) in adolescents are scarce, especially in the Asia-Pacific region. The purpose of this study was to determine whether the prevalence of suspected NAFLD changed between 2001–2005 and 2015–2017. Methods Data were extracted from the Korea National Health and Nutrition Examination Survey (2001–2005 to 2015–2017, n = 4448). Suspected NAFLD was defined by an elevated alanine aminotransferase (ALT) level of >26 IU/L in boys and >22 IU/L in girls. In addition, the analysis was repeated using the Korean cut-off levels for ALT of 33 IU/L for boys and 25 IU/L for girls. Results The prevalence of suspected NAFLD increased, with a relative increase of 44% from 7.8% (95% CI 6.6–9.2%) in 2001–2005 to 11.2% (95% CI 9.7–12.9%) in 2015–2017 (p = 0.001). This increase was evident in both boys (10.6 vs 14.7%, p = 0.01) and girls (4.6 vs 7.4%, p = 0.02). Increases were also observed in obesity (7.3 vs 10.6%), central obesity (10.0 vs 12.8%) and ALT level (14.9 vs 16.7 IU/L). The prevalence of suspected NAFLD was approximately 40–45% in obese/central obese adolescents in 2015–2017. Using the Korean cut-off levels, the prevalence of suspected NAFLD has increased, with a relative increase of 55%, from 4.6% (95% CI 3.7–5.7%) in 2001–2005 to 7.2% (95% CI 6.1–8.5%) in 2015–2017 (p = 0.01). Conclusions The prevalence of suspected NAFLD continues to increase in Korean adolescents. Abbreviations ALT, alanine aminotransferase; BMI, body mass index; KNHANES, Korea National Health and Nutrition Examination Survey; NAFLD, non-alcoholic fatty liver disease.