Approximately one-third of children and teens in the United States are overweight, and 15 percent of children and teens are obese. Fatty liver disease—the excess buildup of fat in the liver--may exist in 15 percent or more of these obese children.
Indiana University School of Medicine researchers are taking a closer look at fatty liver disease, the incidence of which is rising as obesity in children increases. Non-Alcoholic Steatohepatitis, more popularly known as fatty liver disease, is not life threatening in children, but it can lead to cirrhosis (scarring) of the liver, sometimes requiring transplantation by adulthood.
"Until now the only treatment for fatty liver disease has been to offer diet and exercise counseling, but this is often not effective. As part of a national multicenter research network, we are now looking at Vitamin E and at Metformin, a drug used to treat Type II diabetes, as possible therapies" says Jean Molleston, clinical professor of pediatrics at IU School of Medicine and director of pediatric gastroenterology at Riley Hospital for Children. Molleston is the pediatric principal investigator for the IU School of Medicine site of TONIC, an eight-center Phase III study funded by the National Institute of Diabetes and Digestive and Kidney Disease. The study is investigating treatment options for fatty liver disease in 8- to 17- year-olds and is the largest study of its type to date.
"We are seeing a growing number of young people with fatty liver disease, and we need to tackle the disease before it becomes full blown in adulthood,” Molleston says. “We routinely test children for conditions with much lower incidence, such as scoliosis. Although we do not yet have formal guidelines for screening for fatty liver disease, I personally think that all obese children should be screened for it so we can intervene before it damages the liver."
A simple blood test to determine if liver enzyme levels are elevated alerts pediatricians that a child needs to be evaluated for fatty liver disease.
The IU School of Medicine principal investigator for the adult arm of the TONIC study is gastroenterologist Naga Chalasani, associate professor of medicine. Other study sites also have both pediatric and adult arms and are located in California, Maryland, Missouri, Ohio, Virginia, and Washington.
