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Child obesity lies behind alarming fatty liver trend

While hepatitis vaccinations ensure that Taiwan's younger generation will not have to risk contracting hepatitis B, a liver inflammation, physicians are now worried that child obesity could lead to a new liver killer.

One doctor was shocked recently upon examining a child below the age of 10 and discovering the child had a fatty liver and the beginnings of liver fibrosis.

New research shows that one in three obese children in Taiwan have fatty liver. Ultra sound tests done in a study of 245 children with weight problems -- the 5 percent with the highest body mass index from each school age group -- in Taipei County elementary schools showed that 32 percent have developed fatty livers.

Among those 32 percent, 64 percent were in the early stage of developing fatty liver, 22 percent in the middle stage, and 14 percent were in the advanced stage.

Generally speaking, fatty liver does not affect the liver's functions, but blood samples from the children revealed abnormalities in the liver functions of 14.3 percent, 35.2 percent and 72.7 percent of children in the early, middle and advanced stages respectively.

The study found that high insulin resistance was a major factor behind fatty liver and abnormal liver functions.

Chu Feng-nien (祝豐年), community doctor at the Tri-Service General Hospital, said a recent nutritional study showed that obese children are at a one-and-a-half to two times greater risk of developing abnormal liver functions.

Since most children in this age group have received hepatitis B vaccinations, Chu said that fatty liver must be the culprit in the observed cases of abnormal liver functions among obese children.

Hsiao Tun-jen, (蕭敦仁), a part-time doctor at National Taiwan University Hospital, said the fatty liver threat is increasing.

It is already known that fatty liver increases insulin resistance, which leads to reduced fat burning and further accumulation of fat in the liver, thus constituting a vicious cycle, he said.

Excessive fat also leads to an increase in cytokines, which cause cell death and are dangerous to the liver, he said.

If the situation remains unchanged over two or three decades, there is a 10 percent to 20 percent risk that the patient will develop liver fibrosis, cirrhosis of the liver or even liver cancer, he said, adding that these conditions would develop at the same speed as hepatitis B.
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