Prevalence and risk factors for nonalcoholic fatty liver disease in obese children in rural Punjab, India
Nishu Gupta1, Gunjan Jindal2, Anuradha Nadda3, Saloni Bansal4, Shailesh Gahukar5, Ashok Kumar6
1 Department of Pediatrics, PGIMER Satellite Centre Sangrur, Patiala, Punjab, India
2 Department of Radiodiagnosis, PGIMER Satellite Centre Sangrur, Patiala, Punjab, India
3 Department of Community Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India
4 Department of Biochemistry, PGIMER Satellite Centre Sangrur, Patiala, Punjab, India
5 Department of Hospital Administration, PGIMER Satellite Centre Sangrur, Patiala, Punjab, India
6 Department of Hospital Administration, PGIMER, Chandigarh, India
Dr, Anuradha Nadda
Department of Community Medicine, Gian Sagar Medical College and Hospital, (Rajpura), Patiala, Punjab - 140 401
Source of Support: None, Conflict of Interest: None
BACKGROUND: Pediatric nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, hypertension, metabolic syndrome, cardiovascular problems, and increased risk of chronic liver disease and Type II diabetes mellitus. The aim of the study was to assess the metabolic profiles and associated risk factors of NAFLD in obese children.
MATERIALS AND METHODS: Children with a body mass index (BMI) of >27 kg/m2 an adult equivalent cutoff (Indian Academy of Paediatrics, 2015 guidelines) aged 5–18 years presenting to the pediatric outpatient unit of PGIMER Satellite Centre, Sangrur, India, were retrospectively recruited over a 1-year period. Anthropometry, lipid profile, thyroid levels, liver function test, fasting blood sugar, and blood pressure were measured. Ultrasonography was used to diagnose NAFLD. Logistic regression was used to assess the risk factors.
RESULTS: A total of 100 children participated in the study. The mean age was 10.6 ± 2.6 years and the mean BMI-Z score was 2.6 ± 0.5. The prevalence of NAFLD was 62%. Alanine transaminase (ALT) was significantly elevated in all the children with NAFLD. Lipid levels and BMI Z-score were similar in both groups. Unadjusted odds ratio shows statistically significant association of ALT (2.058 [1.11–1.01]) and waist circumference (1.089 [1.19–0.99]) with NAFLD. With adjusted odds ratio only, ALT (1.12 [1.24–1.01]) was found to be significantly associated with NAFLD.
CONCLUSION: There is quite a high prevalence of nonalcoholic fatty liver in obese Indian children. All children with raised liver enzymes should undergo sonography to rule out NAFLD.