Natural History of NAFLD Diagnosed in Childhood: A Single-Center Study.

• Type of Material: Article
• Authors: Catherine E. Cioffi, Emory University; Jean A. Welsh, Emory University; Rebecca L. Cleeton, Emory University; Shelley Caltharp, Emory University; Rene Romero, Emory University; Mark Wulkan, Emory University; Juna V. Konomi, Emory University; Jennifer K. Frediani, Emory University; Miriam Vos, Emory University
• Language: English
• Date: 2017-05-03
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2017 by the authors. Licensee MDPI, Basel, Switzerland.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/children4050034
• Title of Journal or Parent Work: Children
• ISSN: 2227-9067
• Volume: 4
• Issue: 5
• Grant/Funding Information: M.V. (NIH HD089056, DK096157, PD303567-SC105312).
• Keywords: adolescence; longitudinal; BMI; metabolic syndrome; hepatic

Abstract

Little is known regarding the subsequent course of non-alcoholic fatty liver disease (NAFLD) diagnosed in childhood. The objectives of this single-center study were to gather data on long-term health outcomes and to assess the feasibility of contacting former pediatric patients. In a large pediatric medical center, electronic records were searched to initially identify 162 former patients who had a liver biopsy between 2000 and 2010. Of these, 44 subjects met the criteria for age at follow-up (≥18 year) and biopsy-proven NAFLD, and were recruited via postal and electronic mail. Participants were invited to complete a brief telephone survey on current health status. Supplemental data was also obtained from pediatric medical charts of all subjects. At NAFLD diagnosis, 18% of subjects had diabetes, 91% were obese, 61% had NASH, and 56% had fibrosis on biopsy. At follow-up, 10 subjects (23%) responded to the survey. Based on the survey and chart review, after a mean follow-up of 4.5 years, 5 additional subjects developed diabetes for a period prevalence of 30%, and most subjects (78%) remained obese at last follow-up. Additional prospective studies are needed to fully describe the longitudinal risks associated with pediatric NAFLD, and will require multi-dimensional strategies to successfully recruit former patients.