The goal of researchers from the Mayo Clinic in Rochester, MN, led by Dr. Paul Angulo, was to determine the effects of fatty liver disease in children up to 20 years after the initial diagnosis. This is especially important as nonalcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in preadolescents and adolescents. To put the problem of NAFLD into perspective, Ariel Feldstein, MD, another investigator involved with the study said, "In the past ten years, the rate of obesity in our country has tripled in children and teenagers, and this most likely explains why NAFLD is becoming so common. Some experts estimate that about half of obese children may have fatty liver disease."

The authors identified 66 children who were diagnosed with NAFLD and had extensive follow up data available for review. After the initial diagnosis, four children developed type 2 diabetes and four children had increased liver fibrosis. During follow up two children developed end-stage liver disease and required a liver transplantation. However NAFLD recurred in the transplanted liver in the two cases, with one case progressing to cirrhosis and requiring re-transplantation. The study demonstrated that NAFLD in children is associated with a significantly shorter long-term survival as compared to the expected survival of the general population. Children with NAFLD had an almost 14-fold higher risk of dying or requiring liver transplantation than the general population of same age and sex.

"There is currently no medication proven to be effective for NAFLD," development of medications that could treat NAFLD and NASH is an area of intense research," said Dr. Feldstein, "and it remains unclear whether there are any clinical or laboratory features that can be used to identify the subgroup of children with NAFLD that will develop advanced liver disease later in life."

"The most important recommendations for children with fatty liver are to lose weight if they are overweight or obese, increase their physical activity, follow a balanced diet and avoid unnecessary medications," concluded Dr. Feldstein.

Abstract title:

The natural history of nonalcoholic fatty liver disease in children: A follow-up study up to 20 years.

AASLD is the leading medical organization for advancing the science and practice of hepatology. Founded by physicians in 1950, AASLD's vision is to prevent and cure liver diseases. This year's Liver Meeting, held in San Francisco, California, October 31 - November 4, will bring together more than 7,000 researchers from 55 countries.

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