https://pubmed.ncbi.nlm.nih.gov/34321421/ NAFLD

J Pediatr Gastroenterol Nutr. 2021 Jul 27.
doi: 10.1097/MPG.0000000000003253.Online ahead of print.

Unhealthy Eating, Psychopathology, and Nonalcoholic Fatty Liver Disease in Youth Presenting for Bariatric Surgery

Sanita L Ley 1, Meg H Zeller, Jennifer Reiter-Purtill, David E Kleiner, John Dixon, Stavra Xanthakos, Teen View Study Group and in collaboration with the Teen-LABS Consortium
Affiliations expand
PMID: 34321421

Abstract
Objectives: Little is known about the behavioral and psychosocial correlates of pediatric nonalcoholic fatty liver disease (NAFLD). Given diet contributes to the development and persistence of NAFLD, we examined (1) the prevalence of unhealthy eating behaviors (UEB), (2) whether these varied by NAFLD or non-alcoholic steatohepatitis (NASH) presence, and explored (3) the association of psychopathology with NAFLD.

Methods: Prior to metabolic and bariatric surgery (MBS), adolescents (N = 159; Mage = 16.4; MBMI = 53.7 kg/m2, 73% Female, 62.3% White) self-reported presence/absence of 10 UEB (Questionnaire on Eating and Weight Patterns-Revised, Night Eating Questionnaire, Look AHEAD). NAFLD and NASH presence was assessed by intraoperative liver biopsy. Height/weight, blood pressure and blood specimens were obtained. A medical comorbidity index was created (pre-diabetes/diabetes, dyslipidemia, elevated blood pressure). Psychopathology was assessed in a subgroup completeding the Youth Self-Report (N = 98).

Results: Binge eating disorder symptomatology was associated with higher odds of NAFLD while frequent eating out was associated with lower odds of NAFLD. Among those with NAFLD frequent eating out was associated with higher odds of NASH while nocturnal eating was associated with lower odds of NASH. Separate models identified internalizing psychopathology as associated with higher odds of NAFLD after controlling for demographics, number of UEB, and medical comorbidities.

Conclusions: Results suggest potential phenotypical differences between adolescents presenting for MBS with/without NAFLD, with implications for behavioral/psychosocial targets for screening and intervention. Replication should occur in a sample with greater gender and ethnic diversity to improve generalizability. Understanding differences in the context of surgical weight loss and comorbidity resolution is indicated.