Low and High Birth Weights Are Risk Factors for Nonalcoholic Fatty Liver Disease in Children

      Objectives

      To examine the distribution of birth weight in children with nonalcoholic fatty liver disease (NAFLD) compared with the general US population, and to investigate the relationship between birth weight and severity of NAFLD.

      Study design

      A multicenter, cross-sectional study of children with biopsy-proven NAFLD enrolled in the Nonalcoholic Steatohepatitis Clinical Research Network Database. Birth weight was categorized as low birth weight (LBW), normal birth weight (NBW), or high birth weight (HBW) and compared with the birth weight distribution in the general US population. The severity of liver histology was assessed by birth weight category.

      Results

      Children with NAFLD (n = 538) had overrepresentation of both LBW and HBW compared with the general US population (LBW, 9.3%; NBW, 75.8%; HBW, 14.9% vs LBW, 6.1%; NBW, 83.5%; HBW 10.5%; P < .0001). Children with HBW had significantly greater odds of having more severe steatosis (OR, 1.82, 95% CI. 1.15-2.88) and nonalcoholic steatohepatitis (OR, 2.03; 95% CI, 1.21-3.40) compared with children with NBW. In addition, children with NAFLD and LBW had significantly greater odds of having advanced fibrosis (OR, 2.23; 95% CI, 1.08-4.62).

      Conclusion

      Birth weight involves maternal and in utero factors that may have long-lasting consequences. Children with both LBW and HBW may be at increased risk for developing NAFLD. Among children with NAFLD, those with LBW or HBW appear to be at increased risk for more severe disease.

      Keywords

      Abbreviations:

      BMI ( Body mass index), HBW ( High birth weight), LBW ( Low birth weight), NAFLD ( Nonalcoholic fatty liver disease), NASH ( Nonalcoholic steatohepatitis), NASH CRN ( Nonalcoholic Steatohepatitis Clinical Research Network), NBW ( Normal birth weight), VLBW ( Very low birth weight)
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      Linked Article

      • The Highs and Lows of Fetal Programming for Fatty Liver Disease
        The Journal of PediatricsVol. 187
        • In Brief
          Birth weight is determined by a multitude of factors, such as maternal health, parity, nutritional status, genetics, as well as socioeconomic status.1-4 In utero exposures that directly affect birth weight also have epigenetic consequences for the offspring.5,6 As a result, birth weight is a marker of health, as well as an indicator of future disease risk, as suggested by the Barker hypothesis.7 Low and high birth weights (LBW and HBW), typically in conjunction with rapid weight gain early in life, have been associated with obesity8 and features of metabolic dysregulation,9 such as diabetes,10 hypertension,11 dyslipidemia,12 and atherosclerosis13 in late childhood or adulthood.
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