The utility of biomarkers for non-alcoholic fatty liver disease in adolescents

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The liver is the largest glandular organ in the body and is involved in a large number of the body?s normal functions. It produces the chemicals needed to breakdown fat in the circulation and produces cholesterol. It converts glucose (sugar) from the circulation to a form that can be stored and is responsible for maintaining a proper level of glucose in the circulation. It also makes a number of amino acids (the basic building blocks of proteins), stores key vitamins and minerals and filters harmful substances, such as alcohol, from the body. Until recently high levels of alcohol intake were seen as the major cause of liver disease in developed population. However, because of the recent obesity epidemic the most common cause of liver disease in the developed world now is caused by deposits of fat in the liver, so called non-alcoholic fatty liver disease (NALFD). Studies from America suggest that NAFLD starts to occur in adolescence with up to 15% of healthy adolescents in the US having NAFLD. In adults NAFLD can progress to cirrhosis and is also associated with increased risk of diabetes and cardiovascular disease. However, its causes and consequences in adolescents have not been extensively studied because of the difficulties of safely and accurately diagnosing this condition. The most accurate way to diagnose NAFLD is to take a sample (biopsy) from the liver and examine it under a microscope. However, this method is potentially dangerous and very costly and is not practical for large-scale research studies. A number of scanning methods, including ultrasound scan, are also useful for accurate diagnosis but these are too expensive and time consuming for large-scale studies. In this study we aim to develop a way of diagnosing NAFLD in adolescents that would be suitable for large studies of generally healthy young people. We will test a number of blood test results and measurements of total fat and abdominal fat in relation to NAFLD diagnosed by ultrasound scan in 3500 UK individuals aged 17 years. Once we have developed a safe diagnostic tool we will then test it again in an independent group of 17 year olds from Australia, in order to make sure it really is valid. This project brings together an international team of experts in research methods, liver medicine, clinical pathology and liver scanning. Our results will enable the much needed research in this area to progress.