BOSTON – Pediatric nonalcoholic fatty liver disease progresses as children age to a more adult pattern of disease, a paired-biopsy study shows.
“As they grow older, they are facing liver transplant and potentially hepatocellular carcinoma, just as the adults do,” Dr. Elizabeth M. Brunt said during an interview at the annual meeting of the American Association for the Study of Liver Diseases.
Among 102 children studied, the zone 1 (borderline 1b) diagnostic pattern decreased from 27.5% to 9.8%, while the more “adult” NAFLD zone 3 (borderline 1a) pattern and definite steatohepatitis patterns both increased from 14.7% and 28.4% to 18.6% and 29.4%.
Moreover, cirrhosis was seen in nearly 3% of children at first biopsy, but by the second biopsy, nearly 20% of children had advanced fibrosis or cirrhosis, she said.
The findings are troubling because the United States is in the midst of an obesity epidemic, and obesity is associated with high rates of fatty liver disease, said Dr. Brunt of Washington University, St. Louis.
The National Institutes of Health supported the study. Dr. Brunt reported consulting for Synageva, serving as an independent contractor for Rottapharm and Kadmon, and speaking and teaching for the Geneva Foundation.