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Epidemiological features of pediatric nonalcoholic fatty liver disease in China
Xiongfeng Pan1,2, Judy McDonald3,4, Xinrui Tan3
1Pediatrics Research Institute of Hunan Province, the Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), Changsha, China. pxfcsu@163.com.
Insights
Pediatric non-alcoholic fatty liver disease (NAFLD) affects over 22% of children in China. Boys, older children, and those who are overweight or obese show higher prevalence, highlighting the need for urgent public health interventions.
Area of Science:
- Pediatric Gastroenterology and Hepatology
- Public Health and Epidemiology
- Metabolic Disorders
Background:
- Non-alcoholic fatty liver disease (NAFLD) is a growing concern in pediatric populations globally.
- China faces a significant public health challenge with the rising incidence of pediatric NAFLD.
- This study addresses the need for updated epidemiological data on NAFLD in Chinese children and adolescents.
Purpose of the Study:
- To estimate the prevalence of pediatric NAFLD across China.
- To identify key epidemiological characteristics and risk factors associated with pediatric NAFLD.
- To inform public health strategies and interventions for NAFLD control in children.
Main Methods:
- Systematic review of English and Chinese databases for studies published before January 1st, 2025.
- Inclusion and exclusion criteria applied for rigorous screening and data extraction.
- Pooled prevalence calculated using the Freeman-Tukey Double Arcsine Transformation Method with subgroup analyses by region, income, age, and gender.
Main Results:
- Analysis of 219 studies involving 126,682 participants.
- Nationwide prevalence of pediatric NAFLD in China estimated at 22.82%.
- Higher prevalence observed in boys, older children, southern/northeastern regions, and overweight/obese individuals. Metabolic, endocrine, and lifestyle factors identified as key determinants.
Conclusions:
- The substantial burden of pediatric NAFLD in China necessitates effective intervention studies.
- Governmental action is crucial for public awareness and health policies to combat the NAFLD epidemic.
- Targeted interventions focusing on metabolic, endocrine, and lifestyle factors are recommended.
Objective:
Non-alcoholic fatty-liver disease (NAFLD) among children and adolescents in China has emerged as a significant public-health concern, that requires greater attention. This study aims to estimate the prevalence of pediatric NAFLD and its epidemiological characteristics.
Methods:
Four English-language and two Chinese-language databases were systematically searched for relevant articles published before January 1st, 2025. Rigorous inclusion and exclusion criteria were applied to screen articles and extract NAFLD prevalence data. The pooled overall prevalence of NAFLD with 95% confidence intervals (CIs) was calculated using the Freeman-Tukey Double Arcsine Transformation Method. Moreover, subgroup analysis was conducted to compare NAFLD prevalence across different categories, including region, income, age, and gender.
Results:
The study encompassed 126,682 participants from 219 studies. The nationwide prevalence of pediatric NAFLD in China was 22.82%. Higher prevalence rates were observed among boy, older age groups, individuals in southern and northeastern regions, and those classified as obese or overweight. Furthermore, epidemiological pattern analysis of children with NAFLD identified metabolic, endocrine, and lifestyle factors as crucial determinants in pediatric NAFLD progression.
Conclusions:
Considering the substantial burden of pediatric NAFLD in China, researchers must conduct effective intervention studies to address its epidemiological status. Additionally, governmental action is required to enhance public awareness and establish health policies aimed at controlling the NAFLD epidemic among Chinese children.
Trial Registration:
The registration number was CRD42020206731.
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