The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational/prevalence studies
PubMed 26512983 · doi:10.1371/journal.pone.0140908
What was done
A systematic review and meta-analysis evaluating the prevalence of non-alcoholic fatty liver disease (NAFLD) based on any diagnostic modality in children and adolescents aged 1 to 19 years. Subgroup analyses examined variation by BMI category, sex, age, diagnostic method, geographical region, and sample size.
What was found
The pooled mean prevalence of NAFLD was 7.6% (95% CI: 5.5% to 10.3%) in general pediatric populations and 34.2% (95% CI: 27.8% to 41.2%) in pediatric obesity clinic cohorts. Extreme statistical heterogeneity was observed across studies in both populations (I2 = 98%). NAFLD prevalence was higher in males and increased incrementally across BMI categories. In clinical cohorts, prevalence varied by region (highest in Asia). Using elevated alanine aminotransferase (ALT) yielded substantially lower prevalence estimates than biopsy, ultrasound, or magnetic resonance imaging (MRI). No time trends were detected.
Why it matters
This review establishes pooled pediatric NAFLD prevalence benchmarks, confirming a high burden in youth that escalates markedly in the presence of obesity.
Limits
Extreme heterogeneity (I2 = 98%) weakens the reliability of single pooled estimates. Diagnostic criteria varied widely across studies, with ALT systematically underestimating prevalence relative to imaging or biopsy. The abstract does not report the total number of included studies or overall participant count.
Cited by
- supports Between 5% and 10% of children have non-alcoholic fatty liver disease (NAFLD).