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Fatty Liver Disease in Children

Fatty liver disease is a condition in which fat accumulates in the liver. The condition has two major subtypes: nonalcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD). NAFLD is incredibly common, affecting about 25% of the world’s population. And in the United States, rates of NAFLD are rising along with high cholesterol, type 2 diabetes, and obesity; in fact, NAFLD is now the most common chronic liver disorder in the country. NAFLD is split into two further subtypes: nonalcoholic steatohepatitis (NASH) and simple fatty liver

Because fatty liver disease is typically asymptomatic, it’s notoriously challenging to diagnose. As a result, the condition is generally noticed by physicians if they see skewed results on a liver test they ordered for other reasons. If they see abnormal results that point to fatty liver, doctors will generally follow up that test with something else to reach a diagnosis, such as a physical exam, liver biopsy, or imaging and blood tests. In fact, almost all of the Ezra scans may identify fatty liver disease.

The cause behind fatty liver disease depends on the subtype. While AFLD is caused by excessive alcohol consumption, experts have not yet pinpointed the exact cause of NAFLD, though they have identified several risk factors that could increase one’s likelihood of developing the disease. These include:

  • Rapid weight loss
  • Obesity
  • Previous exposure to certain toxins
  • Certain infections, like hepatitis C
  • Having type 2 diabetes/prediabetes
  • Being middle aged or older
  • Having high blood pressure
  • Having high cholesterol or high levels of triglycerides in the blood
  • Having certain metabolic disorders
  • Taking certain cancer drugs or other medications, like corticosteroids
  • Being middle aged or older
  • Being Hispanic followed by being Caucasian (NAFLD is least common in African Americans)

NAFLD can also, however, develop in children as well. The Boston Children’s Hospital considers the disease a “silent” one, listing its only symptoms for many children as experiencing discomfort in the upper right area of the abdomen or feeling tired. Its risk factors in children are largely the same as those listed above. They include:

  • Obesity
  • Prediabetes 
  • Type 2 diabetes
  • Insulin resistance
  • Hepatitis C
  • High lipid disorders
  • Rapid weight loss

Boston Children’s says that they use a “multidisciplinary approach” to caring for children dealing with NAFLD. This includes using non-invasive imaging tests to assess the extent of fat and scarring in the liver, as well as connecting children and their families with weight management programs, since obesity is a major risk factor for NAFLD and many other conditions.