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Low and High Birth Weights Are Risk Factors for Nonalcoholic Fatty Liver Disease in Children
Kimberly P Newton1, Haruna S Feldman2, Christina D Chambers2
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego School of Medicine, La Jolla, CA; Division of Gastroenterology, Department of Pediatrics, Rady Children's Hospital, San Diego, CA.
Insights
Children with nonalcoholic fatty liver disease (NAFLD) show altered birth weights, with both low birth weight (LBW) and high birth weight (HBW) being overrepresented. Both LBW and HBW are associated with increased NAFLD severity and advanced fibrosis in children.
Area of Science:
- Pediatric Hepatology
- Metabolic Disorders
- Public Health
Background:
- Nonalcoholic fatty liver disease (NAFLD) is a growing concern in pediatric populations.
- Birth weight is influenced by maternal and in utero environments, potentially impacting long-term health.
- Understanding birth weight distribution in pediatric NAFLD is crucial for identifying at-risk groups.
Purpose of the Study:
- To compare the birth weight distribution of children with NAFLD to the general US population.
- To investigate the association between birth weight categories (low, normal, high) and NAFLD severity in children.
Main Methods:
- A multicenter, cross-sectional study utilizing the Nonalcoholic Steatohepatitis Clinical Research Network Database.
- Categorization of birth weight into low birth weight (LBW), normal birth weight (NBW), and high birth weight (HBW).
- Comparison of birth weight distributions and assessment of liver histology severity by birth weight category.
Main Results:
- Children with NAFLD exhibited a higher prevalence of both LBW and HBW compared to the general US population (P < .0001).
- High birth weight (HBW) was linked to increased odds of severe steatosis and nonalcoholic steatohepatitis (NASH) compared to NBW.
- Low birth weight (LBW) was associated with significantly greater odds of advanced fibrosis in children with NAFLD.
Conclusions:
- Altered birth weights, both LBW and HBW, are overrepresented in children diagnosed with NAFLD.
- Children with LBW or HBW may face an elevated risk of developing NAFLD.
- Among children with NAFLD, those with LBW or HBW are at higher risk for more severe liver disease outcomes.
Objectives:
To examine the distribution of birth weight in children with nonalcoholic fatty liver disease (NAFLD) compared with the general US population, and to investigate the relationship between birth weight and severity of NAFLD.
Study Design:
A multicenter, cross-sectional study of children with biopsy-proven NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network Database. Birth weight was categorized as low birth weight (LBW), normal birth weight (NBW), or high birth weight (HBW) and compared with the birth weight distribution in the general US population. The severity of liver histology was assessed by birth weight category.
Results:
Children with NAFLD (n = 538) had overrepresentation of both LBW and HBW compared with the general US population (LBW, 9.3%; NBW, 75.8%; HBW, 14.9% vs LBW, 6.1%; NBW, 83.5%; HBW 10.5%; P < .0001). Children with HBW had significantly greater odds of having more severe steatosis (OR, 1.82, 95% CI. 1.15-2.88) and nonalcoholic steatohepatitis (OR, 2.03; 95% CI, 1.21-3.40) compared with children with NBW. In addition, children with NAFLD and LBW had significantly greater odds of having advanced fibrosis (OR, 2.23; 95% CI, 1.08-4.62).
Conclusion:
Birth weight involves maternal and in utero factors that may have long-lasting consequences. Children with both LBW and HBW may be at increased risk for developing NAFLD. Among children with NAFLD, those with LBW or HBW appear to be at increased risk for more severe disease.