Changes in the Prevalences of Obesity, Abdominal Obesity, and Non-Alcoholic Fatty Liver Disease among Korean Children during the COVID-19 Outbreak

Abstract

Purpose: We aimed to investigate the prevalences of obesity, abdominal obesity, and non-alcoholic fatty liver disease (NAFLD) among children and adolescents during the coronavirus disease 2019 (COVID-19) outbreak.

Materials and methods: This population-based study investigated the prevalences of obesity, abdominal obesity, and NAFLD among 1428 children and adolescents between 2018-2019 and 2020. We assessed the prevalences of obesity, abdominal obesity, and NAFLD according to body mass index, age, sex, and residential district. Logistic regression analyses were performed to determine the relationships among obesity, abdominal obesity, and NAFLD.

Results: In the obese group, the prevalence of abdominal obesity increased from 75.55% to 92.68%, and that of NAFLD increased from 40.68% to 57.82%. In age-specific analysis, the prevalence of abdominal obesity increased from 8.25% to 14.11% among participants aged 10-12 years and from 11.70% to 19.88% among children aged 13-15 years. In residential district-specific analysis, the prevalence of both abdominal obesity and NAFLD increased from 6.96% to 15.74% in rural areas. In logistic regression analysis, the odds ratio of abdominal obesity for NAFLD was 11.82.

Conclusion: Our results demonstrated that the prevalences of abdominal obesity and NAFLD increased among obese Korean children and adolescents and in rural areas during the COVID-19 outbreak. Additionally, the prevalence of abdominal obesity increased among young children. These findings suggest the importance of closely monitoring abdominal obesity and NAFLD among children during COVID-19, focusing particularly on obese young children and individuals in rural areas.

Keywords: COVID-19; Obesity; abdominal obesity; adolescent; child; non-alcoholic fatty liver disease.

Fig. 1. Design and flowchart of the study population. KNHANES, Korea National Health and Nutrition Examination Survey; ALT, alanine aminotransferase; HBV, hepatitis B virus; HCV, hepatitis C virus.

Fig. 2. Changes in the proportions of abdominal obesity and NAFLD in children and adolescents according to BMI groups during the COVID-19 outbreak. (A) Changes in the proportions of abdominal obesity in children and adolescents according to BMI during the COVID-19 outbreak. (B) Changes in the proportions of NAFLD in children and adolescents according to BMI during the COVID-19 outbreak. The solid line represents the normal group, the narrow line represents the overweight group, and the dashed line represents the obesity group. NAFLD, non-alcoholic fatty liver disease; BMI, body mass index; COVID-19, coronavirus disease 2019.