Prevalence of non-alcoholic fatty liver disease in pediatric mental disorder inpatients: a tertiary mental health referral hospital study

Abstract

Background and aim: studies have revealed a high prevalence of non-alcoholic fatty liver disease (NAFLD) among adult patients with mental disorders, as well as its associated risk factors. However, little is known about this in the pediatric population. The aim of this study was to investigate the prevalence of NAFLD in pediatric inpatients with a mental disorder, and to explore the risk factors. Methods: in this retrospective study, 1,156 pediatric inpatients with a mental disorder and admitted to our hospital between January 2020 and December 2021 were included, including inpatients with schizophrenia, bipolar disorder, depressive disorder and other mental disorders. Relevant clinical data were obtained from the electronic medical records. The prevalence rate of NAFLD was calculated and compared with gender, mental disorders types, antipsychotics use and comorbidities. Multivariable logistic regression was used to examine risk factors associated with NAFLD. Results: the prevalence of NAFLD in pediatric inpatients with mental disorders was 7.35 % (85/1,156). Patients with NAFLD were older than those without NAFLD (15.33 ± 1.75 vs 14.21 ± 1.95 years-old, p < 0.001). The NAFLD prevalence in participants with schizophrenia (12.11 %) was higher than in participants with bipolar disorder (8.45 %), depressive disorder (7.06 %) and other mental disorders (2.97 %) (p = 0.002). The NAFLD prevalence was higher in participants who used antipsychotics (8.70 %) than in those who did not (5.45 %) (p = 0.038). Multivariate analysis revealed that older age, body weight (overweight/obese) and dyslipidemia were independent risk factors for NAFLD in pediatric inpatients with mental disorders. Conclusions: the NAFLD prevalence was higher in those patients with schizophrenia and receiving antipsychotic medication. Metabolic factors and longer evolution may explain these differences.