Obesity in Children and Adolescents: Add Liver Failure to the list of complications

It is rare that I read an article in the newspaper or in a popular magazine that teaches me something I do not already know in my research field of interest, pediatric endocrinology.  Well, it happened early this morning when I opened my NYT.  On the front page of the paper was an article entitled: ” Threat grows from liver illness tied to obesity, ” written by Anahad O’Connor.  Recent data from several reliable sources show that liver failure in children and adolescents with obesity is on the rise and has doubled in the past 20 years.  The cause of the liver disease is though to be accumulation of fat in the liver, which leads to liver failure, which for all intents and purposes mimics alcoholic liver disease in adults.  The mechanism is thought to be liver inflammation from the fatty infiltration leading to fibrosis, and eventually, liver failure.  The only known treatment is liver transplantation.  At present, about 10% of all liver transplants are due to non-alcoholic fatty livers (the scientific term is non-alcoholic hepatosteatosis or NASH), up from 1% only 10 years ago.  Studies show that people with Hispanic backgrounds are particularly susceptible to the disorder because they carry a gene that increases the ability of the liver to take up and store fats.  This is truly scary news, and we should add NASH to the already long list of reasons we must work harder not only to slow the rise in childhood and adolescent obesity, but to decrease it.

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