Higher number of non-alcoholic fatty liver disease cases

SAN DIEGO (CNS) – The increasing number of obese children is leading to a higher incidence of non-alcoholic fatty liver disease, which can cause premature cardiovascular disease, according to results of a study released Monday by the UC San Diego School of Medicine.

The study, published in the Nov. 24 edition of PLOS One, found that children with NAFLD are at substantial risk for high blood pressure, which is commonly undiagnosed and can result in heart trouble.

“As a result of our study, we recommend that blood pressure evaluation, control and monitoring should be included as an integral component of the clinical management of children with NAFLD, especially because this patient population is at greater risk for heart attacks and strokes,” said Dr. Jeffrey Schwimmer, who teaches in the Department of Pediatrics at UC San Diego School of Medicine.

“Hypertension is a main cause of preventable death and disability in the United States in adults, but much of the origin occurs in childhood,” said Schwimmer, who was a principal investigator of the study.

NAFLD — the inappropriate storage of fat droplets inside liver cells — is the most common cause of chronic liver disease in the United States and affects nearly 10 percent of all children. Although youth with chronic liver disease often have no symptoms, some children with NAFLD will have fatigue and/or abdominal pain, according to UCSD.

The initial evaluation for NAFLD is via a blood test, and diagnosis is ultimately based upon a liver biopsy. The disease is most common in children and teenagers who are overweight and can develop in conjunction with other health problems, such as diabetes.

Researchers measured the blood pressure of 484 children, ages 2-17, for almost a year. Nearly one-third had high blood pressure on their first test, while 21 percent still did at the end of the study period.

“Along with being at an increased risk for cardiovascular disease, we found that children with NAFLD who had high blood pressure were significantly more likely to have more fat in their liver than children without high blood pressure,” Schwimmer said. “This could lead to a more serious form of liver disease.”

The researchers also discovered that girls with NAFLD were significantly more likely to have persistent high blood pressure.

While there are no approved and effective treatments for children with NAFLD, medication to lower blood pressure could prove beneficial for the liver condition, Schwimmer said. Successful treatment of high blood pressure could reduce the risk of premature cardiovascular disease, he said.

“The sooner high blood pressure is identified and treated in this patient population, the healthier they will be as they transition into adulthood,” Schwimmer said.

Anne Zepeda and Kimberly P. Newton of UC San Diego also took part in the study, along with Cynthia Behling of Sharp Healthcare, and researchers with the Johns Hopkins Bloomberg School of Public Health and Cincinnati Children’s Hospital Medical Center.

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