Prevalence and Predictors of Non-Alcoholic Fatty Liver Disease in Obese and Overweight Children in the Northwest of Iran

Background: Over recent decades, with the increase in the prevalence of childhood overweight/obesity, the prevalence of pediatric non-alcoholic fatty liver disease (NAFLD) has increased. Objectives: The aim of this study was to investigate the prevalence of NAFLD and its predisposing factors in overweight and obese children of Urmia, Northwest of Iran. Methods: In this cross-sectional study, a total of 843 children aged 2 to 19 years were recruited out of 10800 children referred to the Digestive Disease Clinic of Shahid Motahari Hospital during 2016 - 2017. Anthropometric and laboratory measurements and abdominal ultrasound were performed for the children. Demographic data and their medical history were collected by a questionnaire. Unconditional logistic regression was used to predict the predisposing factors of NAFLD. Results: Fatty liver was diagnosed by ultrasound in 9.5% of overweight and 21.4% of obese children. The prevalence of NAFLD in obese children was 9.26% for the 2 - 5.9-year age group, 22.3% for the 6 - 11.9-year age group and 35.5% for the 12 - 19-year age group. Compared to the normal liver group, the adjusted odds ratios (ORs) [95% confidence interval (CI)] for predictive factors of NAFLD were as follows: ALT: 1.05 (1.03 - 1.09), ALK: 1.02 (1.01 - 1.03), AST: 1.04 (1.02 - 1.08), triglycerides: 1.1 (1. 08 - 1.21), TSH: 1.18 (1.1 - 1.40), FBS: 1.04 (1.01 - 1.08) and HOMA-IR: 1.19 (1.03 - 1.38). Compared to the age group of 2 - 5.9 years, the odds ratio of NAFLD was increased by 4 and 8 times in the age group 6 - 11.9 and 12 - 19 years, respectively. Conclusions: There was a strong relationship between pediatric NAFLD and ALT, AST and HOMA-IR in the overweight and obese children. Our findings emphasized the importance of prevention of obesity and early intervention to prevent abnormalities among obese children.