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. 2017 May 3;4(5):34.
doi: 10.3390/children4050034.

Natural History of NAFLD Diagnosed in Childhood: A Single-Center Study

Catherine E Cioffi  1 , Jean A Welsh  2   3 , Rebecca L Cleeton  4 , Shelley A Caltharp  5 , Rene Romero  6   7 , Mark L Wulkan  8   9 , Juna V Konomi  10 , Jennifer K Frediani  11 , Miriam B Vos  12   13   14
Affiliations

Natural History of NAFLD Diagnosed in Childhood: A Single-Center Study

Catherine E Cioffi et al. Children (Basel). .

Abstract

Little is known regarding the subsequent course of non-alcoholic fatty liver disease (NAFLD) diagnosed in childhood. The objectives of this single-center study were to gather data on long-term health outcomes and to assess the feasibility of contacting former pediatric patients. In a large pediatric medical center, electronic records were searched to initially identify 162 former patients who had a liver biopsy between 2000 and 2010. Of these, 44 subjects met the criteria for age at follow-up (≥18 year) and biopsy-proven NAFLD, and were recruited via postal and electronic mail. Participants were invited to complete a brief telephone survey on current health status. Supplemental data was also obtained from pediatric medical charts of all subjects. At NAFLD diagnosis, 18% of subjects had diabetes, 91% were obese, 61% had NASH, and 56% had fibrosis on biopsy. At follow-up, 10 subjects (23%) responded to the survey. Based on the survey and chart review, after a mean follow-up of 4.5 years, 5 additional subjects developed diabetes for a period prevalence of 30%, and most subjects (78%) remained obese at last follow-up. Additional prospective studies are needed to fully describe the longitudinal risks associated with pediatric NAFLD, and will require multi-dimensional strategies to successfully recruit former patients.

Keywords: BMI; adolescence; hepatic; longitudinal; metabolic syndrome.

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Conflict of interest statement

M.V. has research funding from Resonance Health, Immuron Ltd., Target Pharmasolutions and consulting for Intercept, Aegerion, Allergan and Shire.

Figures

Figure 1
Figure 1
Flow diagram of eligible subjects throughout the study.
Figure 2
Figure 2
Kaplan-Meier survival curves for time to diabetes diagnosis. (a) Time to event starting from birth for the full sample of subjects; (b) Time to event starting at liver biopsy, excluding n = 12 subjects who were censored at time of biopsy.
Figure 3
Figure 3
Change in BMI (kg/m2) from baseline to follow-up for each subject (dotted lines) and overall (solid line), stratified by subgroup: (a) Bariatric surgery subjects or (b) NAFLD-only subjects. Excludes n = 12 subjects who were lost-to-follow-up after biopsy diagnosis.
See this image and copyright information in PMC

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