Most overweight and obese Indian children have nonalcoholic fatty liver disease
Background and rationale. Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease in western countries. Its prevalence in Indian subcontinent is not well studied.Material and methods. In a school based cross sectional study we have screened overweight and obese c...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2016-11-01
|
| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119311111 |
| _version_ | 1818649496390729728 |
|---|---|
| author | Sunil V. Pawar Vinay G. Zanwar Ajay S. Choksey Ashok R. Mohite Samit S. Jain Ravindra G. Surude Qais Q. Contractor Pravin M. Rathi Ravi U. Verma Premlata K. Varthakavi |
| author_facet | Sunil V. Pawar Vinay G. Zanwar Ajay S. Choksey Ashok R. Mohite Samit S. Jain Ravindra G. Surude Qais Q. Contractor Pravin M. Rathi Ravi U. Verma Premlata K. Varthakavi |
| author_sort | Sunil V. Pawar |
| collection | DOAJ |
| description | Background and rationale. Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease in western countries. Its prevalence in Indian subcontinent is not well studied.Material and methods. In a school based cross sectional study we have screened overweight and obese children in the age group of 11 to 15 years for NAFLD. Ultrasonography, elevated serum transaminases, fibroscan were used for defining NAFLD. Dietary habits, blood pressure, serum lipid profile, blood counts and insulin resistance were recorded. The relation of fibrosis 4 score, pediatric NAFLD fibrosis index, aspartate transaminases to platelet ratio index (APRI) with fibroscan was evaluated.Results. Out of 616 students screened 198 were overweight and obese. Hundred students and their parents gave informed consent for the further evaluation. The prevalence of NAFLD was 62% in overweight and obese children. Fatty liver was found in 50 % students on ultrasonography, liver stiffness (≥ 6.1 Kilopascals) in 23% and raised alanine transaminase in 30%. Hypertension, dyslipidemia, diabetes mellitus and insulin resistance were seen in 6%, 18%, 2% and 66% students respectively. Systolic hypertension, serum triglyceride, aspartate transaminase, APRI was significantly higher in the NAFLD group. On binary logistic regression only systolic hypertension was an independent risk factor for NAFLD.Conclusion. In conclusion NAFLD is common in asymptomatic overweight and obese Indian children. Systolic hypertension is the only independent factor associated with NAFLD. Fibroscan has limited role for screening. We recommend screening for NAFLD in this high risk group with alanine transaminases and ultrasonography. |
| first_indexed | 2024-12-17T01:35:15Z |
| format | Article |
| id | doaj.art-2d0c3b514f704b38b6717a691e9a7c09 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-17T01:35:15Z |
| publishDate | 2016-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-2d0c3b514f704b38b6717a691e9a7c092022-12-21T22:08:28ZengElsevierAnnals of Hepatology1665-26812016-11-01156853861Most overweight and obese Indian children have nonalcoholic fatty liver diseaseSunil V. Pawar0Vinay G. Zanwar1Ajay S. Choksey2Ashok R. Mohite3Samit S. Jain4Ravindra G. Surude5Qais Q. Contractor6Pravin M. Rathi7Ravi U. Verma8Premlata K. Varthakavi9Department of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, India; Correspondence and reprint request:Department of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, IndiaDepartment of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, IndiaDepartment of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, IndiaDepartment of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, IndiaDepartment of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, IndiaDepartment of Gastroenterology & Hepatology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, IndiaDepartment of Gastroenterology & Hepatology, Bombay Hospital Institute of Medical Science (BHIMS) and Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, IndiaDepartment of Radio diagnosis, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, IndiaDepartment of Endocrinology, Topiwala National Medical College & B Y L Nair Hospital, Mumbai, Maharashtra, IndiaBackground and rationale. Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease in western countries. Its prevalence in Indian subcontinent is not well studied.Material and methods. In a school based cross sectional study we have screened overweight and obese children in the age group of 11 to 15 years for NAFLD. Ultrasonography, elevated serum transaminases, fibroscan were used for defining NAFLD. Dietary habits, blood pressure, serum lipid profile, blood counts and insulin resistance were recorded. The relation of fibrosis 4 score, pediatric NAFLD fibrosis index, aspartate transaminases to platelet ratio index (APRI) with fibroscan was evaluated.Results. Out of 616 students screened 198 were overweight and obese. Hundred students and their parents gave informed consent for the further evaluation. The prevalence of NAFLD was 62% in overweight and obese children. Fatty liver was found in 50 % students on ultrasonography, liver stiffness (≥ 6.1 Kilopascals) in 23% and raised alanine transaminase in 30%. Hypertension, dyslipidemia, diabetes mellitus and insulin resistance were seen in 6%, 18%, 2% and 66% students respectively. Systolic hypertension, serum triglyceride, aspartate transaminase, APRI was significantly higher in the NAFLD group. On binary logistic regression only systolic hypertension was an independent risk factor for NAFLD.Conclusion. In conclusion NAFLD is common in asymptomatic overweight and obese Indian children. Systolic hypertension is the only independent factor associated with NAFLD. Fibroscan has limited role for screening. We recommend screening for NAFLD in this high risk group with alanine transaminases and ultrasonography.http://www.sciencedirect.com/science/article/pii/S1665268119311111Body Mass IndexFibroscanHomeostasis model assessment estimated insulin resistanceUltrasonographySerum glutamic pyruvate transaminase |
| spellingShingle | Sunil V. Pawar Vinay G. Zanwar Ajay S. Choksey Ashok R. Mohite Samit S. Jain Ravindra G. Surude Qais Q. Contractor Pravin M. Rathi Ravi U. Verma Premlata K. Varthakavi Most overweight and obese Indian children have nonalcoholic fatty liver disease Annals of Hepatology Body Mass Index Fibroscan Homeostasis model assessment estimated insulin resistance Ultrasonography Serum glutamic pyruvate transaminase |
| title | Most overweight and obese Indian children have nonalcoholic fatty liver disease |
| title_full | Most overweight and obese Indian children have nonalcoholic fatty liver disease |
| title_fullStr | Most overweight and obese Indian children have nonalcoholic fatty liver disease |
| title_full_unstemmed | Most overweight and obese Indian children have nonalcoholic fatty liver disease |
| title_short | Most overweight and obese Indian children have nonalcoholic fatty liver disease |
| title_sort | most overweight and obese indian children have nonalcoholic fatty liver disease |
| topic | Body Mass Index Fibroscan Homeostasis model assessment estimated insulin resistance Ultrasonography Serum glutamic pyruvate transaminase |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119311111 |
| work_keys_str_mv | AT sunilvpawar mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease AT vinaygzanwar mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease AT ajayschoksey mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease AT ashokrmohite mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease AT samitsjain mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease AT ravindragsurude mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease AT qaisqcontractor mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease AT pravinmrathi mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease AT raviuverma mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease AT premlatakvarthakavi mostoverweightandobeseindianchildrenhavenonalcoholicfattyliverdisease |