Prevalence and outcome of non-alcoholic fatty liver disease in adolescents and young adults undergoing weight loss surgery

Pediatr Obes. 2014 Oct;9(5):e91-3. doi: 10.1111/j.2047-6310.2014.219.x. Epub 2014 Mar 27.

Abstract

Background/objective: We evaluated the prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) in 27 adolescents referred for weight loss surgery (WLS).

Results: On biopsy, 18 patients (66.7%) had NAFLD, and of those, 10 (37.0%) had NASH and 11 (40.7%) had fibrosis. Insulin, HbA1C and homeostatic model assessment of insulin resistance (HOMA-IR) were significantly higher in patients with NASH than those without NASH. Following WLS, 40% of patients with NASH had persistently elevated aminotransferase levels despite weight loss.

Conclusion: We found that NASH is underdiagnosed in adolescents referred for WLS, and that hyperinsulinaemia, HOMA-IR and HbA1c can aid in identifying high-risk patients.

Keywords: Adolescence; Roux-en-Y gastric bypass; non-alcoholic fatty liver disease; obesity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bariatric Surgery / methods*
  • Biomarkers / metabolism
  • Body Mass Index
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / pathology*
  • Disease Progression
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Insulin Resistance
  • Liver / pathology*
  • Liver Function Tests
  • Male
  • Non-alcoholic Fatty Liver Disease / blood
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Non-alcoholic Fatty Liver Disease / pathology*
  • Obesity, Morbid / blood
  • Obesity, Morbid / surgery*
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / pathology*
  • Sleep Apnea, Obstructive / surgery
  • Transaminases / metabolism
  • Treatment Outcome
  • United States / epidemiology
  • Weight Loss*

Substances

  • Biomarkers
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Transaminases