For Obese Kids, Health Problems May Start Early

Nonalcoholic fatty liver disease and high blood pressure risks were raised among obese children

(RxWiki News) As more children become obese, related health problems like nonalcoholic fatty liver disease may be putting their health at risk.

A new study found that non-alcoholic fatty liver disease was prevalent among obese children. This condition may put children at greater risk for high blood pressure than those who are obese without liver disease.

Obesity has more than doubled in children and quadrupled in adolescents in the past 30 years, according to the Centers for Disease Control and Prevention (CDC). Living with excess weight has been tied to a host of health problems. Obese youth face a greater risk of heart disease and diabetes.

"As a result of our study, we recommend that blood pressure evaluation, control and monitoring should be included as an integral component of the clinical management of children with [nonalcoholic fatty liver disease], especially because this patient population is at greater risk for heart attacks and strokes," said lead study author Jeffrey B. Schwimmer, MD, of the University of California - San Diego School of Medicine, in a press release. "Hypertension is a main cause of preventable death and disability in the United States in adults, but much of the origin occurs in childhood. The sooner high blood pressure is identified and treated in this patient population, the healthier they will be as they transition into adulthood."

A total of 484 children with nonalcoholic fatty liver disease participated in this study. They were between the ages of 2 and 17. Their mean body mass index (BMI) was 32.7. BMI is a height- and weight-based measure of body fat. According to the CDC, a BMI of 25 to 29.9 is considered overweight, and 30 or higher is obese.

Close to 36 percent of these children had high blood pressure at the start of the study. Almost a year later, 21 percent continued to have high blood pressure.

Dr. Schwimmer and team noted that past studies have shown that the prevalence of high blood pressure among obese children as a whole was about 11 percent. About 2 to 5 percent of all children had high blood pressure.

“Although most children with [nonalcoholic fatty liver disease] are overweight or obese, our finding that more than one of every three children with [the disease] had high blood pressure at baseline indicates that children with [nonalcoholic fatty liver disease] are at particularly increased risk for high blood pressure,” Dr. Schwimmer and team wrote.

Dr. Schwimmer added that children with nonalcoholic fatty liver disease who had high blood pressure were significantly more likely to have more fat in their livers than children without high blood pressure.

“This could lead to a more serious form of liver disease," Dr. Schwimmer said.

Nonalcoholic fatty liver disease is the buildup of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. If the liver’s weight reaches more than 5 to 10 percent in fat, the condition is unhealthy. Untreated nonalcoholic fatty liver disease is the most common cause of chronic liver disease in the US, according to the American Liver Foundation.

Dr. Schwimmer and colleagues also found that boys with nonalcoholic fatty liver disease were more likely than girls with the disease to have persistent high blood pressure.

Although chronic liver disease may often have no symptoms, some young people with nonalcoholic fatty liver disease may experience fatigue or abdominal pain. The disease is usually diagnosed through a blood test and, ultimately, a liver biopsy (removing a small sample of the liver for analysis). High blood pressure is often undiagnosed in children, the study authors wrote.

The American Liver Foundation notes that there are no current medical treatments for nonalcoholic fatty liver disease. Eating a healthy diet and exercising regularly may prevent liver damage from starting or even reverse the disease in its early stages.

This study was published Nov. 24 in PLOS ONE.

Dr. Schwimmer and colleagues disclosed no funding sources or conflicts of interest.

Review Date: 
November 24, 2014