Prevalence of non-alcoholic fatty liver disease in children and relationship to metabolic syndrome, insulin resistance, and waist circumference

Abstract

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, 37 children were diagnosed as having NAFLD (score C 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 assessmentinsulin 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. Conclusion The prevalence of NAFLD in children and adolescents is closely related to metabolic syndrome, insulin resistance, and WC. © The Japanese Society for Hygiene 2009.