PEDIATRICS Vol. 118 No. 4 October 2006, pp. 1388-1393 (doi:10.1542/peds.2006-1212)
ARTICLE |
Prevalence of Fatty Liver in Children and Adolescents
a Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics
b Department of Family and Preventive Medicine
d Department of Pathology, University of California, San Diego School of Medicine, San Diego, California
c Office of the Medical Examiner, County of San Diego, San Diego, California
OBJECTIVE. Fatty liver disease is diagnosed increasingly in children, but the prevalence remains unknown. We sought to determine the prevalence of pediatric fatty liver as diagnosed by histology in a population-based sample.
METHODS. We conducted a retrospective review of 742 children between the ages of 2 and 19 years who had an autopsy performed by a county medical examiner from 1993 to 2003. Fatty liver was defined as 
5% of hepatocytes containing macrovesicular fat.
RESULTS. Fatty liver was present in 13% of subjects. For children and adolescents age 2 to 19 years, the prevalence of fatty liver adjusted for age, gender, race, and ethnicity is estimated to be 9.6%. Fatty liver prevalence increases with age, ranging from 0.7% for ages 2 to 4 up to 17.3% for ages 15 to 19 years. Fatty liver prevalence differs significantly by race and ethnicity (Asian: 10.2%; black: 1.5%; Hispanic: 11.8%; white: 8.6%). The highest rate of fatty liver was seen in obese children (38%).
CONCLUSIONS. Fatty liver is the most common liver abnormality in children age 2 to 19 years. The presence of macrovesicular hepatic steatosis in 
1 of every 10 children has important ramifications for the long-term health of children and young adults. The influence of the risk factors identified should be taken into consideration in the development of protocols designed to screen at-risk children and adolescents.
Key Words: obesity • nonalcoholic fatty liver disease • steatohepatitis • Hispanic American • metabolic syndrome
Abbreviations: SCALE—Study of Child and Adolescent Liver Epidemiology
Accepted May 22, 2006.
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