https://www.ncbi.nlm.nih.gov/pubmed/31651803 NAFLD
J Pediatr Gastroenterol Nutr. 2019 Oct 23. doi: 10.1097/MPG.0000000000002523. [Epub ahead of print]
Childhood Obesity: A Risk Factor for Non-alcoholic Fatty Liver Disease in Adolescence.
Benítez VC1, Alberti G1, Uauy R1,2, Pereira A2, García C1, de Barbieri F1, Corvalán C2, Santos JL1, Mericq V3, Villarroel L1, Gana JC1.

Abstract
Non-alcoholic fatty liver disease (NAFLD), defined as fat accumulation >5% in hepatocytes, may progress to fibrosis or cirrhosis later in life. NAFLD prevalence in adolescents has increased significantly in direct relation with obesity prevalence. Fatty liver has become the most frequent indication for liver transplantation in adults.

OBJECTIVE:
To identify anthropometric variables during the first 10 years of life associated to the risk of developing NAFLD in adolescence.

METHODS:
Longitudinal cohort study 'Growth and Obesity Chilean Cohort Study' (GOCS) consisting of 513 children born in 2002-2003, with yearly anthropometric data collected over a 10 year period. The presence of intra-hepatic fat in the livers of subjects 14-16 years of age was determined using abdominal ultrasound. In addition, elastography was performed on all participants with ultrasound evidence of NAFLD.

RESULTS:
9.7% of the participants presented findings compatible with NAFLD. After 2 years of age, obesity significantly and progressively increased the probability of NAFLD occurrence in adolescence. Obesity at 5 years of age was associated with the highest OR for NAFLD, reaching values of 8.91 (95% CI 3.03-16.11). Among participants with NAFLD, those with altered liver elasticity (≥7 Kpa) had greater weight, BMI z-score, waist and hip circumference and altered liver enzymes (p < 0.05).

CONCLUSION:
The risk of developing NAFLD in adolescence increases progressively with early obesity starting at age 2 years.