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Chinese Journal of Evidence-Based Pediatrics ›› 2022, Vol. 17 ›› Issue (2): 109-115.

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7-year longitudinal prevalence of nonalcoholic fatty liver disease in children and adolescents in Shanghai Minhang District: A cross-sectional survey from 2014 to 2020

CHEN Xiaotian 1, WEN Xiaosa 2, ZHANG Yi 1, ZHU Xiaoning 2, DOU Yalan 1, HAN Yan 2, WANG Yin 1, HU Yuhuan 2, HE Wennan 1, CHEN Hongyan 1, YAN Weili 1,3   

  1. 1 Children's Hospital of Fudan University, Shanghai 201102, China; 2 Center for Disease Control and Prevention in Minhang District, Shanghai 201100, China; 3 Research Unit of Early Intervention of Genetically Related Childhood Cardiovascular Diseases (2018RU002), Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2021-11-23 Revised:2021-12-24 Online:2022-04-25 Published:2022-04-25
  • Contact: YAN Weili,email:yanwl@fudan.edu.cn

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Abstract: Background：Childhood nonalcoholic fatty liver disease (NAFLD) can significantly increase the risk of cardiovascular disease in adults, however, the studies investigating the NAFLD prevalence in general children and adolescents were scarce and the longterm tendencies of NAFLD prevalence is unclear. Objective：To assess the trend of NAFLD prevalence in children and adolescents. Design：A cross-sectional survey. Methods：Resident students aged 11-17 years who annually participated in the 20142020 routine health checks in Shanghai, Minhang District were included for the analysis. Suspected NAFLD was defined by the elevation of 97.5 percentile of alanine aminotransferase (ALT) levels according to the age and sexspecific reference intervals for the healthy children. The general obesity and abdominal obesity were defined by the body mass index (BMI) and waist according to the China national standards for pediatric population. The annual prevalence change of NAFLD was depicted by calculating the average annual percentage change (AAPC) and 95% confidence intervals (CIs). We used logistic regression by adjusting BMI and waist circumference to assess the temporal trend of NAFLD prevalence over years. Main outcome measures：NAFLD prevalence. Results：The overall NAFLD prevalence was 5.1% increasing 2.5 times from 2014 to 2020 (2.1% to 7.4%), with an AAPC of 0.9% (95%CI: 0.1-1.7) and Ptrend<0.001. Boys had a higher level of NAFLD rate than that of girls (6.3% vs 3.7%). The NAFLD rate in normal weight population was 1.9%, and the elevated trend was still observed in normal weight (Ptrend<0.001) among the 7-year survey. After adjusting BMI and waist, the NAFLD prevalence was still had an increasing trend over year (Ptrend<0.001). Conclusion：NAFLD prevalence of children and adolescents in Shanghai increased nearly 1.0% per year. The increasing trend of NAFLD prevalence remains even after adjustment for BMI and waist. This trend calls for attention on the modifiable risk factors in addition to obesity in this population.

Key words: Nonalcoholic fatty liver disease, Children and adolescents, Obesity, Prevalence