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The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis.

Anderson EL, Howe LD, Jones HE, Higgins JP, Lawlor DA, Fraser A - PLoS ONE (2015)

Bottom Line: There was evidence that prevalence was generally higher in males compared with females and increased incrementally with greater BMI.There was no evidence that prevalence changed over time.Prevalence estimates in studies of children/adolescents attending obesity clinics and in obese children/adolescents from the general population were substantially lower when elevated alanine aminotransferase (ALT) was used to assess NAFLD compared with biopsies, ultrasound scan (USS) or magnetic resonance imaging (MRI).

View Article: PubMed Central - PubMed

Affiliation: MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.

ABSTRACT

Background & aims: Narrative reviews of paediatric NAFLD quote prevalences in the general population that range from 9% to 37%; however, no systematic review of the prevalence of NAFLD in children/adolescents has been conducted. We aimed to estimate prevalence of non-alcoholic fatty liver disease (NAFLD) in young people and to determine whether this varies by BMI category, gender, age, diagnostic method, geographical region and study sample size.

Methods: We conducted a systematic review and meta-analysis of all studies reporting a prevalence of NAFLD based on any diagnostic method in participants 1-19 years old, regardless of whether assessing NAFLD prevalence was the main aim of the study.

Results: The pooled mean prevalence of NAFLD in children from general population studies was 7.6% (95%CI: 5.5% to 10.3%) and 34.2% (95% CI: 27.8% to 41.2%) in studies based on child obesity clinics. In both populations there was marked heterogeneity between studies (I2 = 98%). There was evidence that prevalence was generally higher in males compared with females and increased incrementally with greater BMI. There was evidence for differences between regions in clinical population studies, with estimated prevalence being highest in Asia. There was no evidence that prevalence changed over time. Prevalence estimates in studies of children/adolescents attending obesity clinics and in obese children/adolescents from the general population were substantially lower when elevated alanine aminotransferase (ALT) was used to assess NAFLD compared with biopsies, ultrasound scan (USS) or magnetic resonance imaging (MRI).

Conclusions: Our review suggests the prevalence of NAFLD in young people is high, particularly in those who are obese and in males.

No MeSH data available.


Related in: MedlinePlus

Meta-analysis of within-study comparisons of NAFLD prevalence in males versus females in general population studies.
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pone.0140908.g004: Meta-analysis of within-study comparisons of NAFLD prevalence in males versus females in general population studies.

Mentions: 15 general and 27 clinical obese population studies reported NAFLD prevalence stratified by gender. Meta-analysis of these gender-specific results (Table 1) shows that prevalence estimates were higher on average in males than females in both general population and clinical studies, although confidence intervals overlapped. Interestingly, when stratified by both diagnostic method and gender (Table D in S1 File), prevalence estimates in general population studies were similar in males and females in studies using USS, but higher in males in studies using ALT to assess NAFLD. In clinical population studies, pooled estimates were consistently higher in males, regardless of the diagnostic method used. Meta-analysis of within-study comparisons of NAFLD prevalence in males versus females in general population and clinical studies provided statistical evidence that males have higher prevalence of NAFLD than females, although with considerable heterogeneity across studies (pooled OR of males versus females in general population studies = 1.63, 95% CI: 1.10 to 2.41, I2 = 89%, Fig 4 and pooled OR in clinical obese studies = 2.02, 95%CI: 1.59 to 2.58, I2 = 73%, Fig 5).


The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis.

Anderson EL, Howe LD, Jones HE, Higgins JP, Lawlor DA, Fraser A - PLoS ONE (2015)

Meta-analysis of within-study comparisons of NAFLD prevalence in males versus females in general population studies.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4626023&req=5

pone.0140908.g004: Meta-analysis of within-study comparisons of NAFLD prevalence in males versus females in general population studies.
Mentions: 15 general and 27 clinical obese population studies reported NAFLD prevalence stratified by gender. Meta-analysis of these gender-specific results (Table 1) shows that prevalence estimates were higher on average in males than females in both general population and clinical studies, although confidence intervals overlapped. Interestingly, when stratified by both diagnostic method and gender (Table D in S1 File), prevalence estimates in general population studies were similar in males and females in studies using USS, but higher in males in studies using ALT to assess NAFLD. In clinical population studies, pooled estimates were consistently higher in males, regardless of the diagnostic method used. Meta-analysis of within-study comparisons of NAFLD prevalence in males versus females in general population and clinical studies provided statistical evidence that males have higher prevalence of NAFLD than females, although with considerable heterogeneity across studies (pooled OR of males versus females in general population studies = 1.63, 95% CI: 1.10 to 2.41, I2 = 89%, Fig 4 and pooled OR in clinical obese studies = 2.02, 95%CI: 1.59 to 2.58, I2 = 73%, Fig 5).

Bottom Line: There was evidence that prevalence was generally higher in males compared with females and increased incrementally with greater BMI.There was no evidence that prevalence changed over time.Prevalence estimates in studies of children/adolescents attending obesity clinics and in obese children/adolescents from the general population were substantially lower when elevated alanine aminotransferase (ALT) was used to assess NAFLD compared with biopsies, ultrasound scan (USS) or magnetic resonance imaging (MRI).

View Article: PubMed Central - PubMed

Affiliation: MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.

ABSTRACT

Background & aims: Narrative reviews of paediatric NAFLD quote prevalences in the general population that range from 9% to 37%; however, no systematic review of the prevalence of NAFLD in children/adolescents has been conducted. We aimed to estimate prevalence of non-alcoholic fatty liver disease (NAFLD) in young people and to determine whether this varies by BMI category, gender, age, diagnostic method, geographical region and study sample size.

Methods: We conducted a systematic review and meta-analysis of all studies reporting a prevalence of NAFLD based on any diagnostic method in participants 1-19 years old, regardless of whether assessing NAFLD prevalence was the main aim of the study.

Results: The pooled mean prevalence of NAFLD in children from general population studies was 7.6% (95%CI: 5.5% to 10.3%) and 34.2% (95% CI: 27.8% to 41.2%) in studies based on child obesity clinics. In both populations there was marked heterogeneity between studies (I2 = 98%). There was evidence that prevalence was generally higher in males compared with females and increased incrementally with greater BMI. There was evidence for differences between regions in clinical population studies, with estimated prevalence being highest in Asia. There was no evidence that prevalence changed over time. Prevalence estimates in studies of children/adolescents attending obesity clinics and in obese children/adolescents from the general population were substantially lower when elevated alanine aminotransferase (ALT) was used to assess NAFLD compared with biopsies, ultrasound scan (USS) or magnetic resonance imaging (MRI).

Conclusions: Our review suggests the prevalence of NAFLD in young people is high, particularly in those who are obese and in males.

No MeSH data available.


Related in: MedlinePlus