The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis.
The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis.
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DOI：
10.1371/journal.pone.0140908
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Fraser A
中科院分区：
文献类型：
--
作者：
Anderson EL;Howe LD;Jones HE;Higgins JP;Lawlor DA;Fraser A
儿科NAFLD的叙述性综述引用了一般人群中的患病率范围为9%至37%;然而，尚未对儿童/青少年NAFLD的患病率进行系统性综述。我们的目的是估计非酒精性脂肪肝（NAFLD）在年轻人中的患病率，并确定这是否因BMI类别，性别，年龄，诊断方法，地理区域和研究样本量而异。我们对所有基于任何诊断方法报告1-19岁参与者NAFLD患病率的研究进行了系统回顾和荟萃分析，无论评估NAFLD患病率是否是研究的主要目的。来自一般人群研究的儿童NAFLD合并平均患病率为7.6%（95%CI：5.5%至10.3%），基于儿童肥胖诊所的研究为34.2%（95%CI：27.8%至41.2%）。在两个人群中，研究之间存在显著异质性（I2 = 98%）。有证据表明，男性的患病率通常高于女性，并随着BMI的增加而递增。有证据表明，在临床人群研究中，各区域之间存在差异，亚洲的估计流行率最高。没有证据表明流行率随时间而变化。与活检、超声扫描（USS）或磁共振成像（MRI）相比，使用丙氨酸氨基转移酶（ALT）升高评估NAFLD时，在肥胖诊所就诊的儿童/青少年和普通人群中的肥胖儿童/青少年研究中的患病率估计值显著较低。我们的综述表明，NAFLD在年轻人中的患病率很高，特别是在肥胖和男性中。
Narrative reviews of paediatric NAFLD quote prevalences in the general population that range from 9% to 37%; however, no systematic review of the prevalence of NAFLD in children/adolescents has been conducted. We aimed to estimate prevalence of non-alcoholic fatty liver disease (NAFLD) in young people and to determine whether this varies by BMI category, gender, age, diagnostic method, geographical region and study sample size. We conducted a systematic review and meta-analysis of all studies reporting a prevalence of NAFLD based on any diagnostic method in participants 1–19 years old, regardless of whether assessing NAFLD prevalence was the main aim of the study. The pooled mean prevalence of NAFLD in children from general population studies was 7.6% (95%CI: 5.5% to 10.3%) and 34.2% (95% CI: 27.8% to 41.2%) in studies based on child obesity clinics. In both populations there was marked heterogeneity between studies (I2 = 98%). There was evidence that prevalence was generally higher in males compared with females and increased incrementally with greater BMI. There was evidence for differences between regions in clinical population studies, with estimated prevalence being highest in Asia. There was no evidence that prevalence changed over time. Prevalence estimates in studies of children/adolescents attending obesity clinics and in obese children/adolescents from the general population were substantially lower when elevated alanine aminotransferase (ALT) was used to assess NAFLD compared with biopsies, ultrasound scan (USS) or magnetic resonance imaging (MRI). Our review suggests the prevalence of NAFLD in young people is high, particularly in those who are obese and in males.