Non-alcoholic fatty liver disease (NAFLD), a precursor of serious liver disorders including cirrhosis of the liver and liver cancer, has now started to affect India's youth.
Experts estimate that almost 17%-40% of obese children in India, aged between 8-20 years, are now being diagnosed with fatty liver following ultrasound tests in various hospitals.
According to Dr Archana Arya, adolescent endocrinologist at Sir Ganga Ram Hospital, 55 out of 133 obese children coming to the hospital in the past year were diagnosed with fatty liver.
Paediatrician Dr Anupam Sibal from Apollo hospital said over five cases of paediatric fatty liver was now being diagnosed every week. In a study conducted by Dr Deepak Amarapurkar, liver specialist at Bombay Hospital and Medical Research Centre, involving 1,500 people from 500 families living in the railway colonies of Mumbai, the number of children suffering from fatty liver rose from 2% among children aged five years to 10% in those aged about 20.
Professor of paediatrics at SGPGI, Lucknow, Dr Surinder Yachha also recorded a similar trend among children from prosperous families in Kanpur, Lucknow and Varanasi.
According to these experts, NAFLD is the most chronic and serious consequence of childhood obesity. However, it receives very little attention. The majority of children who have NAFLD go undiagnosed.
"NAFLD generally is asymptomatic and so most parents don't know that their children are suffering from it. This is why we have started screening obese children for NAFLD. An ultrasound test is the easiest way of diagnosing NAFLD early. We can't afford to wait for symptoms to appear," Dr Arya said.
According to Dr Sibal and Dr Amarapurkar, the primary cause for this sudden trend is serious lifestyle flaws among children. Dr Sibal said, "Every week, patients with a mean age of 12 come with NAFLD to me and that's very young for this to be happening. Only about 1 in 10 of the patients have any symptoms."
He added, "We now know that obese children run a high risk of NAFLD. So paediatricians testing children for lipids, BP and insulin resistance must not forget to undertake an ultrasound of the liver. In Delhi alone, 12%-18% children are obese. Those diagnosed with NAFLD must be immediately put on a diet regimen and exercise routine, six times a week, 30 minutes a day." Till recently, NAFLD was a medical condition found only among adults. International studies have now found that of all obese adolescents, between 50%-75% would have NAFLD.
NAFLD is defined by an accumulation of fat in the liver cells. The diagnosis is significant because the disease can lead to cirrhosis and end-stage liver disease requiring a liver transplant. Sometimes, it is severe enough to produce steatohepatitis, an inflammation caused by fat build-up in the liver which over time causes progressive liver damage.