Fatty Liver Disease Ups Heart Risks for Obese Kids

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In addition, children with NAFLD had lower levels of HDL cholesterol (the good cholesterol), Schwimmer's group found.

"Overweight children with NAFLD were three times as likely to have metabolic syndrome as overweight children without NAFLD," Schwimmer said. "Overweight children with metabolic syndrome, compared to overweight children without metabolic syndrome, have five times the odds of having NAFLD," he said.

Schwimmer's group noted that more Hispanic and Asian children had NAFLD compared with white and black children.

NAFLD is becoming more common among overweight children and is associated with type 2 diabetes and the metabolic syndrome, which puts children at risk for cardiovascular disease and type 2 diabetes.

"Since 2002, the numbers of children we are seeing with NAFLD and the severity of the disease we are seeing have both increased a great deal," Schwimmer said.

Currently, there are no treatments for NAFLD, Schwimmer said. "Lifestyle therapy is the main method of treatment. Some people can have tremendous improvement in their disease with nutrition and physical activity, but that's not true for everybody," he said.

Overweight or obese children who should be screened for NAFLD include those with a family history of liver disease or cardiovascular disease or diabetes, Schwimmer said.

Most people with chronic liver disease will not have symptoms, Schwimmer said. "Approximately 25 percent of people with chronic liver disease have symptoms. These can be vague and include abdominal pain and fatigue," he said.

"There is a sign that some children will have," Schwimmer said. "There is a darkening and thickening of the skin around the neck called acanthosis nigricans. Many children with NAFLD will have at least some degree of acanthosis nigricans," he said.

Dr. Sarah de Ferranti, director of the Preventive Cardiology Clinic at Children's Hospital Boston, labeled NAFLD as yet another serious consequence of the obesity epidemic among children.

"The well-publicized pandemic of pediatric obesity has many consequences," de Ferranti said. "Nonalcoholic fatty liver disease is a less well known, but increasingly appreciated, late complication of severe obesity that can lead to cirrhosis and liver failure," she said.