Abstract
BackgroundNonalcoholic fatty liver disease (NAFLD) is a global problem and pediatric obesity has risen dramatically. Early NAFLD might progress to nonalcoholic steatohepatitis (NASH) or liver cirrhosis and significantly increase liver disease-related mortality. We looked for NAFLD predictors in children and adolescents.MethodsThis community-based, cross-sectional study ran from December 2012 to September 2013 in southwestern Taiwan. Children <10 and >19 years old, with detected hepatic diseases, or who drank alcohol were excluded. The diagnosis of NAFLD was based on ultrasound: age, sex, anthropometric measurements, and laboratory data were evaluated for associated risks by using logistic regression analysis. Receiver operating characteristic (ROC) curves were used to determine cutoff values.ResultsWe enrolled one thousand, two hundred and ten children (594 males; 616 females; mean age: 15.5 ± 2.8 years). Age, anthropometric measurements, and laboratory data were significantly higher in children with NAFLD. The association between NAFLD and the waist-to-height ratio (WHtR) was significant (adjusted odds ratio: 2.6; 95% confidence interval: 1.909-3.549; P < 0.001). It indicated highly suspicion of NAFLD (sensitivity: 70.1%; specificity 76.9%) when the WHtR for children and adolescents is above the cutoff value of 0.469.ConclusionsThe WHtR might be a powerful index of the severity of pediatric NAFLD.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is a global problem and pediatric obesity has risen dramatically
Non-alcoholic fatty liver disease (NAFLD) is an emerging health problem associated with childhood obesity and adult metabolic syndrome (MetS) [1]
NAFLD might be an early manifestation of insulin resistance [2], and body fat distribution is important because high abdominal adiposity reflects excess central and visceral adipose tissue (VAT), which is intimately associated with metabolic disease and adverse outcomes in adulthood [3]
Summary
Nonalcoholic fatty liver disease (NAFLD) is a global problem and pediatric obesity has risen dramatically. Non-alcoholic fatty liver disease (NAFLD) is an emerging health problem associated with childhood obesity and adult metabolic syndrome (MetS) [1]. One meta-analysis [10] showed evidence to support the superiority of measuring centralized obesity, especially the WHtR, rather than BMI and waist circumference, for detecting cardiovascular risk factors both in men and in women. The WHtR has been proposed as a more reliable anthropometric index for detecting childhood obesity [11], body fat percentage [12], and Lee et al [13] reported the effects of the WHtR on visceral fat and metabolic components in Korean children and adolescents. We try to assess the reliability of anthropometric indices for hepatosteatosis in Taiwanese children and adolescents
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