Fatty liver disease is important because a small subset of children will develop cirrhosis and end-stage liver disease. As if that was not enough, data from a large study of overweight children with and without NAFLD, showed that having fatty liver is an important risk factor for developing type 2 diabetes and cardiovascular disease (Circulation 2008;118:277-83).
There is no doubt that, since the guidelines have come out, there is a greater level of awareness among primary care providers about the risk of liver disease in overweight and obese children. However, the resulting level of action is still not where it needs to be. More attention needs to be paid toward providing guidance and resources to primary care physicians once they do identify a young patient with NAFLD.
JEFFREY B. SCHWIMMER, M.D., is director of the Fatty Liver Clinic at Rady Children's Hospital in San Diego. He reported having no conflicts of interest.
