Metabolic Syndrome in Childhood from Impaired Carbohydrate Metabolism to Nonalcoholic Fatty Liver Disease

Abstract

Compelling evidence supports the concept that nonalcoholic fatty liver disease (NAFLD) represents the hepatic component of metabolic syndrome (MetS). Intrahepatic fat seems to predict more strongly than does visceral adiposity an individual's cardiovascular risk and the likelihood that metabolic abnormalities are present in youth.

Key teaching points:

•	Overweight and obese youth should be screened for fatty liver disease once after puberty by liver function tests and ultrasonography.
•	Screening for fatty liver should be accurately performed in young patients with features of metabolic syndrome.
•	Obese patients with fatty liver are at increased risk for altered glucose metabolism, thus they should undergo an oral glucose tolerance test.
•	A nutritional and behavioral intervention aimed at achieving a permanent change of the lifestyle in patients and their parents is recommended.

Key words::

• insulin resistance
• nonalcoholic fatty liver disease
• metabolic syndrome
• pediatric obesity
• type 2 diabetes mellitus

Table 1. Ongoing Clinical Trials for the Treatment of Obese Children with MetS and/or NAFLD [58]

Notes

This work has been presented at the 51st meeting of the American College of Nutrition.