Paediatrics and Child Health, Aga Khan University Hospital, Nairobi, Kenya
Paediatrics and Child Health, Aga Khan University Hospital, Nairobi, Kenya.
BMJ Open Gastroenterol. 2023 Feb;10(1). doi: 10.1136/bmjgast-2022-001044.
While linked to obesity and associated with an increased cardiovascular morbidity, non-alcoholic fatty liver disease (NAFLD) is an often-asymptomatic cause of chronic liver disease in children. Early detection provides opportunity for interventions to curb progression. Childhood obesity is on the rise in low/middle-income countries, but cause-specific mortality data associated with liver disease are scanty. Establishing the prevalence of NAFLD in overweight and obese Kenyan children would guide in public health policies aimed at early screening and intervention.
To investigate prevalence of NAFLD in overweight and obese children aged 6-18 years using liver ultrasonography.
This was a cross-sectional survey. After obtaining informed consent, a questionnaire was administered, and blood pressure (BP) measured. Liver ultrasonography was performed to assess fatty changes. Categorical variables were analysed using frequency and percentages. χ test and multiple logistic regression model were used to determine relationship between exposure and outcome variables.
Prevalence of NAFLD was 26.2% (27/103, 95% CI=18.0% to 35.8%). There was no association between sex and NAFLD (OR1.13, p=0.82; 95% CI=0.4 to 3.2). Obese children were four times more likely to have NAFLD compared with overweight children (OR=4.52, p=0.02; 95% CI=1.4 to 19.0). About 40.8% (n=41) had elevated BP, but there was no association with NAFLD (OR=2.06; p=0.27; 95% CI=0.6 to 7.6). Older children (13-18 years) were more likely to have NAFLD (OR 4.42; p=0.03; 95% CI=1.2 to 17.9).
Prevalence of NAFLD was high in overweight and obese school children in Nairobi. Further studies are needed to identify modifiable risk factors to arrest progression and prevent sequelae.
非酒精性脂肪性肝病（NAFLD）与肥胖相关，并增加心血管疾病发病率，是儿童慢性肝病的常见病因，通常无明显症状。早期发现可为遏制疾病进展提供干预机会。在中低收入国家，儿童肥胖症的发病率呈上升趋势，但与肝病相关的特定病因死亡率数据却很少。确定超重和肥胖肯尼亚儿童中 NAFLD 的患病率将有助于制定旨在早期筛查和干预的公共卫生政策。
使用肝脏超声检查调查超重和肥胖儿童中 NAFLD 的患病率。
这是一项横断面调查。在获得知情同意后，进行问卷调查并测量血压（BP）。进行肝脏超声检查以评估脂肪变化。使用频率和百分比分析分类变量。 χ 检验和多因素逻辑回归模型用于确定暴露和结局变量之间的关系。
NAFLD 的患病率为 26.2%（27/103，95%CI=18.0%至 35.8%）。性别与 NAFLD 之间无关联（OR1.13，p=0.82；95%CI=0.4 至 3.2）。与超重儿童相比，肥胖儿童患 NAFLD 的可能性高 4 倍（OR=4.52，p=0.02；95%CI=1.4 至 19.0）。约 40.8%（n=41）的儿童血压升高，但与 NAFLD 无关（OR=2.06；p=0.27；95%CI=0.6 至 7.6）。年龄较大的儿童（13-18 岁）更有可能患有 NAFLD（OR 4.42；p=0.03；95%CI=1.2 至 17.9）。
在内罗毕的超重和肥胖学龄儿童中，NAFLD 的患病率较高。需要进一步研究以确定可改变的危险因素，以遏制疾病进展并预防并发症。
