Metabolic Syndrome and Risk for Non-Alcoholic Fatty Liver Disease in Overweight and Obese Children

Objective: To study the prevalence of metabolic syndrome in overweight/obese children and its association with nonalcoholic fatty liver disease. Patients and Methods: Thirty-four overweight and obese children, age 2 to 13 years, body mass index (BMI) ^! 85 th percentile, were studied for the prevalence of metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD). Laboratory analysis included fasting blood glucose, serum insulin, serum triglyceride, total cholesterol, high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and liver function tests. Additional liver ultrasound and liver biopsy to evaluate presence of fatty liver. Results: The prevalence of waist circumference (WC) ≥90th percentile, fasting blood glucose ^! 100mg/dl, HDL-c !940mg/dl and serum triglyceride ^! 110mg/dl was 97%, 23.5%, 64.7%, 79.4% respectively. The prevalence of 3 or more MetS criteria was 62%. Patients with 3 or more MetS were more likely to have low HDL-c, high triglyceride and more fatty liver by biopsy (p=0.00 1). Fifteen (44%) patients had biopsy proven NAFLD. Compared patients with normal liver histology, those with NAFLD were more likely to have higher BMI, WC, alanine aminotransferase (ALT), total cholesterol, LDLc, triglyceride, insulin level and low HDL-c ( p=0.001). Conclusion: The prevalence of MetS was high among obese children. Evidence of NAFLD was more common in patients meeting three or more criteria for MetS than in those meeting fewer criteria. Those patients meeting criteria for MetS should be evaluated for NAFLD.