Non-alcoholic fatty liver disease in children and adolescents: a meta-analysis

Aim: Non-alcoholic fatty liver disease is the most common chronic liver disease in children and adolescents. It is associated with various risk factors including obesity, metabolic syndrome, sedentary lifestyle, etc. The present study was aimed to give an overview of the latest data on the prevalence and treatment options for non-alcoholic fatty liver disease in children and adolescents. Materials and methods: For the purpose of this meta-analysis, we conducted a comprehensive systematic literature review including a PubMed database search for related studies until September 2021. A thorough selection process was then adopted to select eligible studies for further analysis. Results: The selected prevalence studies in this meta-analysis included 27,241 children and adolescents, with a pooled mean prevalence of 22.64%. There was a marked heterogeneity (I2 = 43%) and a significant difference (p < 0.00001) in the prevalence of non-alcoholic fatty liver disease among children and adolescents across the studies. The results also showed a greater prevalence of non-alcoholic fatty liver disease in adolescents as compared to children. The most widely used method for the estimation of prevalence among selected studies was alanine transaminase levels. However, various treatment strategies were adopted in different studies for non-alcoholic fatty liver disease in children/adolescents, and changes in body mass index and aminotransferase levels (alanine transaminase/aspartate transaminase) were used as outcome measures after treatment. Overall, there was a non-significant difference in body mass index values (p = 0.02) among the selected studies. However, the combined effect of alanine transaminase by using a random model was 13.52 (7.28, 19.76), and a significant difference in pooled alanine transaminase values (p < 0.00001) was observed after treatment. Conclusion: There is a high prevalence of non-alcoholic fatty liver disease among children and adolescents. However, lifestyle interventions and other treatment methods have a significant impact on reducing the occurrence of the disease in children and adolescents.