The Effect of Weight Loss on Pediatric Nonalcoholic Fatty Liver Disease

This study evaluated the effect of weight loss on pediatric nonalcoholic fatty liver disease (NAFLD). Subjects included 81 overweight NAFLD patients referred to two pediatric gastroenterologists from 2000 to 2010. Data on subjects were obtained from review of medical charts. The effect of weight loss was assessed at 1-4 months, 5-8 months, 9-12 months, and beyond one year as the change in weight, BMI z-score (for age-and-sex), and alanine aminotransferase and the relationship between the change in body weight and BMI z-score, and the change in alanine aminotransferase. Subjects were mostly obese (99%), male (86%), and Asian (63%) and had median age of 14.1 (11.2-16.2) years and alanine aminotransferase of 105 (78-153) U/L at referral. Alanine aminotransferase decreased 32 ± 66 (P = 0.016), 30 ± 65 (P = 0.134), 37 ± 75 (P = 0.0157), and 45 ± 69 (P = 0.014) for subjects with follow-up data at 1-4 months (n = 47), 5-8 months (n = 26), 9-12 months (n = 19), and beyond one year (n = 19), respectively. During these time periods, neither was body weight (-0.2 to +7.1 kg) or BMI z-score (-0.12 to -0.05) significantly reduced, nor were changes in these variables associated with the change in alanine aminotransferase. These findings suggest that weight and BMI z-score may not be sufficient indicators of treatment response in pediatric NAFLD patients.