Original ArticlePancreas, Biliary Tract, and LiverPrevalence of Liver Steatosis and Fibrosis Detected by Transient Elastography in Adolescents in the 2017–2018 National Health and Nutrition Examination Survey
Section snippets
Study Design and Population
The present study represents an analysis of data from the 2017–2018 cycles of NHANES, which is conducted in the United States by the National Center for Health Statistics (NCHS), part of the Centers for Disease Control and Prevention. NHANES is a cross-sectional survey program that uses a stratified, multistage, clustered probability sampling design to include individuals representative of the general, noninstitutionalized population ≥2 months of age. Full methodology of data collection is
Results
Clinical and metabolic features of the 867 study participants are shown in Table 1. Mean age was 15.1 years, 52% were male, about one-fifth were obese, and 4.3% had elevated blood pressure. Any degree of steatosis was present in 240 individuals (weighted prevalence 24.16%; 95% confidence interval [CI], 21.07%–27.24%), and 123 had S3 steatosis (weighted prevalence 11.63%; 95% CI, 9.19%–14.06%). No participant tested positive for either hepatitis C antibodies or hepatitis B surface antigen, and
Discussion
This is to our knowledge the first study reporting estimates on the prevalence of MAFLD and significant fibrosis in adolescents from the general U.S. population by means of transient elastography. We found that approximately 1 in 10 adolescents had a CAP ≥280 dB/m (indicative of S3 steatosis), and almost 1 in 20 had evidence of increased liver stiffness, suggestive of significant fibrosis. Our results align with previous data on adolescents from the 1999–2004 NHANES cycles, which showed a
References (34)
- et al.
Prevalence of elevated alanine aminotransferase among US adolescents and associated factors: NHANES 1999-2004
Gastroenterology
(2007) - et al.
Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents
J Pediatr
(2000) - et al.
Association between fibrosis stage and outcomes of patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis
Gastroenterology
(2020) - et al.
A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C
Hepatology
(2003) - et al.
Individual patient data meta-analysis of controlled attenuation parameter (CAP) technology for assessing steatosis
J Hepatol
(2017) - et al.
Predicting hepatic steatosis in a racially and ethnically diverse cohort of adolescent girls
J Pediatr
(2014) - et al.
Prevalence of steatosis and fibrosis in young adults in the UK: a population-based study
Lancet Gastroenterol Hepatol
(2020) - et al.
NAFLD and liver transplantation: current burden and expected challenges
J Hepatol
(2016) - et al.
Nonalcoholic fatty liver disease in children
Semin Liver Dis
(2018) - et al.
Nonalcoholic fatty liver disease in children: not a small matter
Paediatr Drugs
(2018)
MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease
Gastroenterology
The prevalence of non-alcoholic fatty liver disease in children and adolescents: a systematic review and meta-analysis
PLoS One
The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years
Gut
Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up
Hepatology
Accuracy and reproducibility of transient elastography for the diagnosis of fibrosis in pediatric nonalcoholic steatohepatitis
Hepatology
Combined paediatric NAFLD fibrosis index and transient elastography to predict clinically significant fibrosis in children with fatty liver disease
Liver Int
Transient elastography is a useful noninvasive tool for the evaluation of fibrosis in paediatric chronic liver disease
J Pediatr Gastroenterol Nutr
Cited by (0)
Conflicts of interest The authors disclose no conflicts.