A new US study finds that nearly one third of children with non-alcoholic fatty liver disease (NAFLD) also have prediabetes or type 2 diabetes.
NAFLD develops when fat builds up within the liver, commonly affecting people who are overweight or obese. If its progression is severe enough, it can lead to liver failure.
Researchers at the Fatty Liver Clinic at Rady Children’s Hospital, San Diego, analysed 675 children with NAFLD, all of whom were under the age of 18. The average Body Mass Index (BMI) of the children was 32 – the threshold for obesity is 30.
The study team, led by Dr. Jeffrey B. Schwimmer, wanted to determine the prevalence of type 2 diabetes and prediabetes within the children, given the lack of research data available.
They found that 23 per cent of the kids with NAFLD had prediabetes and seven per cent had type 2 diabetes. Girls with NAFLD were five times more likely to have type 2 diabetes than boys.
Over 40 per cent of children with type 2 diabetes also had non-alcoholic steatohepatitis (NASH), the second stage of NAFLD. NASH is a more severe form of liver disease which occurs when the liver becomes damaged and subsequently inflamed.
Schwimmer and colleagues stressed the need for lifestyle improvements within the children, including increased Nutrition, physical activity and better mental well-being.
Increased nutrition can be provided by increased intake of vegetables and meals prepared at homen, and cutting out processed foods.
They also recommend that children with NAFLD receive blood glucose testing and be monitored for progression of liver disease and type 2 diabetes.
“Although children with NAFLD overall are typically boys, girls with NAFLD are more likely to have diabetes,” said Schwimmer.
“Special attention should be given to children with the combination of type 2 diabetes and NASH, as they are at particularly high risk for premature morbidity and mortality.”
The findings appear in JAMA Pediatrics.

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