Researchers have warned that the rates of pediatric liver disease and type 2 diabetes are rising among children. Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric liver disease, and it is estimated that rates of type 2 diabetes have doubled in children over the past 20 years. Now, a study by US researchers has suggested that pediatric liver disease can lead to type 2 diabetes. Keep reading to understand the connection between these two diseases.
While NAFLD has been associated with type 2 diabetes in adults, less is known about a similar connection in children. The study, published in Clinical Gastroenterology and Hepatology, has revealed that children with NAFLD have features of insulin resistance, a key characteristic of type 2 diabetes, indicating that they may be at risk for developing the disease.
The US research team is led by Jeffrey Schwimmer, professor of pediatrics at University of California San Diego School of Medicine and director of the Fatty Liver Clinic at Rady Children's Hospital-San Diego.
They found that among 892 children with NAFLD enrolled for the studied, type 2 diabetes was present in 6.6 per cent of the children at initial assessment, with the incidence rate increasing 3 per cent annually over the next four years. By the end of the study, one in every six children had developed type 2 diabetes.
The finding is alarming, said Schwimmer, adding that "type 2 diabetes in youth is a much more aggressive disease than in adults, with more immediate and serious complications and outcomes."
The researchers identified specific factors that increase the risk of type 2 diabetes in children with NAFLD. These include sex (females were more likely to develop type 2 diabetes), severity of obesity and the amount of fat and scar tissue in the liver.
Schwimmer noted that gastroenterologists caring for children with NAFLD should be aware of the risk and provide monitoring, anticipatory guidance and lifestyle interventions that help their patients avoid developing type 2 diabetes.
Nonalcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in the liver, which can affect the function of the liver. (NASH) is an advanced form of NAFLD in which a child has inflammation of the liver and liver damage, in addition to fat in the liver. This can lead to scarring of the liver.
Overweight or obese children and those with metabolic syndrome and type 2 diabetes are more likely to develop NAFLD and NASH. Children may be at high risk of developing this condition if they: follow a poor diet and do little or no exercise, have dyslipidaemia irregular level of blood lipids and carry certain variations in their genes.
Most children with NAFLD do not display symptoms in the early stages. It is often when significant damage to the liver has occurred that signs become more obvious. In advanced form, patients may experience symptoms such as:
If the child develops cirrhosis (which is the most advanced stage of the liver disease), the following symptoms may be present:
Currently, no medicines have been approved to treat NAFLD in children. Children who are overweight or obese are generally recommended to lose weight to treat nonalcoholic fatty liver disease, by eating healthily and regular exercise. The gradual weight loss can reduce fat, inflammation, and fibrosis in the liver.
