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Non-alcoholic fatty liver disease in children

BMJ 2011; 343 doi: (Published 18 July 2011) Cite this as: BMJ 2011;343:d4460
  1. C Ronny L H Cheung, clinical adviser 1,
  2. Deirdre A Kelly, professor2
  1. 1Department of Health, Richmond House, London SW1A 2NS, UK
  2. 2Liver Unit, Birmingham Children’s Hospital, Birmingham B4 6NH, UK
  1. Correspondence to: crcheung{at}
  • Accepted 11 July 20011

Non-alcoholic fatty liver disease (NAFLD) is now one of the most common reasons for referral for chronic liver disease in children and young people in the developed world.1 As in adults, NAFLD is associated with obesity, insulin resistance, and type 2 diabetes mellitus but may also be present in several inherited disorders associated with insulin resistance, such as Alström syndrome and Bardet-Biedl syndrome.2 Various studies have suggested NAFLD rates in children of 2.6-9.8%,3 rising to 10-77% among obese children.1 Childhood NAFLD has both similarities to and differences from adult NAFLD and, and as with adult NAFLD, presents diagnostic, prognostic, and treatment uncertainties.

Recognition and diagnosis

Non-invasive diagnostic tests such as ultrasonography and alanine aminotransferase are as non-specific in children as in …

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