Challenges in Screening for Pediatric Nonalcoholic Fatty Liver Disease

Related Experiment Video

Updated: Feb 21, 2026

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
05:56

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis

Published on: August 29, 2025

600

Anna E Ferguson1, Stavra A Xanthakos1, Robert M Siegel1

  • 11 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Clinical Pediatrics
|October 13, 2017
PubMed

Insights

Screening for nonalcoholic fatty liver disease (NAFLD) in obese children is challenging. Many children with elevated liver enzymes in a pediatric weight program did not complete recommended follow-up testing.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Obesity Medicine

Background:

  • Nonalcoholic fatty liver disease (NAFLD) is a leading cause of elevated liver enzymes in US children.
  • Published guidelines recommend NAFLD screening for children with obesity.
  • The implementation of these recommendations in pediatric weight management settings is not well-defined.

Purpose of the Study:

  • To characterize NAFLD screening practices within a large pediatric weight management program.
  • To assess the rate of elevated liver enzymes and subsequent diagnostic steps in this cohort.

Main Methods:

  • Retrospective chart review of patients in a pediatric weight management program during 2014.
  • Analysis of liver enzyme panels and follow-up laboratory testing.
  • Inclusion criteria: patients seen in the program, liver enzyme data available.

Main Results:

  • A total of 1312 patients were evaluated; liver enzyme panels were obtained for 847 (64.5%).
  • 5.5% (47/847) had liver enzymes elevated twice the upper limit of normal.
  • Of those with elevated enzymes, 70% (33/47) had persistent elevations, and 67% (22/33) underwent further exclusionary testing.

Conclusions:

  • Screening for NAFLD in pediatric weight management programs presents significant challenges.
  • Adherence to recommended exclusionary testing for elevated liver enzymes is suboptimal.
  • Barriers preventing completion of further diagnostic evaluations require identification and intervention.

Keywords:
abdominal ultrasoundnonalcoholic fatty liver disease (NAFLD)outcomesscreeningweight management

More Related Videos

Author Spotlight: Establishing MASLD Cell Models for Investigating Disease Mechanisms and the Lipid-Lowering Effects of Koumiss07:03

Author Spotlight: Establishing MASLD Cell Models for Investigating Disease Mechanisms and the Lipid-Lowering Effects of Koumiss

Published on: July 19, 2024

1.9K
Incorporation of a Survivable Liver Biopsy Procedure in Mice to Assess Non-alcoholic Steatohepatitis NASH Resolution04:14

Incorporation of a Survivable Liver Biopsy Procedure in Mice to Assess Non-alcoholic Steatohepatitis NASH Resolution

Published on: April 16, 2019

12.7K

Related Concept Videos

Ultrasound II: Endoscopic Ultrasound and FibroScan01:25

Ultrasound II: Endoscopic Ultrasound and FibroScan

Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
818
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
223
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
269
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
346
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
350