NAFLD Prevalence Increasing in Pediatric Patients

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Dr. Miriam Vos details the TARGET-NASH study, which indicated a higher prevalence of NAFLD in pediatric patients than previously thought.

Last week, a new investigation confirmed a higher prevalence of non-alcoholic fatty liver disease (NAFLD) in pediatric patients than previously thought.

The data was part of the ongoing observational study called TARGET-NASH, which included participants with NAFLD and/or alcoholic steatohepatitis (NASH).

The study, which included 660 pediatric patients, cited an increase in liver disease following evaluation of alanine aminotransferase.

Notably, pediatric patients with greater than 250 U/L ATL had an eight-fold greater risk of developing cirrhosis.

For this episode of DocTalk, Miriam Vos, MD, MSPH, Department of Pediatrics, School of Medicine, Emory University, sat down with assistant managing editor Kenny Walter to discuss the data from TARGET-NASH as well as the implications of NAFLD in pediatric patients.

Vos has studied the disease for 16 years, and the database included in the trial followed the children for an average of 5 years. She noted that current information on NAFLD in children is limited, and that the ongoing trial data could lead to a greater understanding of the disease.

“We don't have a lot of studies that cover from childhood to adulthood; we have many studies in kids, following them for a number of years, and in this study we have data from about 3 years of follow up,” Vos said. “So, I don't know that we really know if there's a difference in management. Is an adult who has had the disease starting in childhood, do they have a more severe disease? Possibly, but we still are collecting the data as these children aged into adulthood to try to answer that question.”

She added that while most children are not affected by advanced fibrosis, the medical community would benefit from markers that look at steatosis and additional testing to measure inflammation levels in the liver.

“That adds to the information from the ALT, and then a noninvasive marker of fibrosis would be critical,” Vos said. “Because the ones with more fibrosis in childhood certainly are the ones that we would want to tailor medicines for.”

Currently, there is no therapeutic approved by the Food and Drug Administration for pediatric nephrology.