Background: Pediatric non alcoholic fatty liver disease (NAFLD) is an important cause of chronic liver disease in children in absence of significant alcohol consumption.

Etiology of NAFLD is related to genetic predisposition, insulin resistance and obesity. In order to evaluate incidence, clinical and investigational profile of children with NAFLD the following study was conducted.

Methods: The children (age 3 – 12 yrs) who attend pediatric gastroenterology OPD of PGIMER, Chandigarh from July 1993 to June 2003 with feature of NAFLD were admitted to pediatric gastroenterology ward of PGIMER, Chandigarh.

Exclusion criteria was HBsAgl, HIV positivity, low cerulospasmin, high serum globulin, SMA/ANA positive etc.

The clinical profile (BMI / family history / daily physiological activity etc.), investigations (USG whole abdomen / blood sugar (F) / lipid profile / T3 T4 THS / FT4 / MR elastography / transient elastography / HBsAg / anti HIV / cerulospasmin / LFT etc) were done.

Lifestyle modification (diet / exercise) was done. Regular follow up was done till resolution of fatty liver.

Results: Fatty children were admitted in pediatric GE ward of PGIMER, Chandigarh from July 1993 to June 2003. Age was 3 – 12 yrs (mean 10 yrs) male was 30, female was 20. Overweight was 10 (BMI percentile 91 – 98) and obese was 40 (BMI percentile 98 – 99.6). twenty children were low birth weight (<2.5 kg at birth), 5 were large for date, 25 were norman AGA (appropriate for gestational age) at birth. Dietetic history shows consumption of >20% calories according to age. Small screen spending time (TV / mobile) was > 2 hours / day in 35 children (70%). Physical activity was less in 40 children (80%) cases. Blood sugar / lipid profile. LFT was normal in all 50 children. Nobody had NASH. Fatty liver was detected in all 50 children by USG.

Conclusion: NAFLD is an important cause of mortality / morbidity in children. Non invasive modality like USG whole abdomen / biometry / MR elastography / are more important in pediatric NAFLD rather than liver biopsy.

Though life style modification is mainstay of treatment for pediatric NAFLD, promising therapeutic agent is needed for children.

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Sujay Chaudhuri

Division of pediatric Gastroenterology, Department of Gastroenterology, PGIMER Chandigarh