Researchers Target Liver Disease in Kids

Two types of fatty cell illness diagnosed in obese children

TUESDAY, May 18, 2004 (HealthDayNews) -- Just two decades ago, doctors assumed only alcoholics could develop a condition that clogs their livers with fat, but it turned out that obese children could also suffer from the condition.

Now, researchers have pinpointed two variations of the pediatric version of the disease.

Dr. Jeffrey Schwimmer, an assistant professor of pediatrics at the University of California at San Diego, said the findings could help doctors develop ways to treat nonalcoholic fatty liver disease in children. Currently, there's little to do other than urge the kids to fight the illness by losing weight.

"There are no pills to take at this point in time," Schwimmer said. "I'm sure there will be. But we need the science. It's not enough to guess. We need to know what does and doesn't work."

In both children and adults, fatty liver disease occurs when fat deposits build up inside liver cells. "The function of the cells is impaired, and the liver cells can no longer do their jobs," explained Dr. Anna Lok, a professor of internal medicine at the University of Michigan.

As the liver cells begin to malfunction, abdominal pain can develop along with serious conditions such as cirrhosis (scarring), hepatitis and even liver cancer.

The liver handles many jobs in the body, including the filtering of foreign substances such as alcohol, and booze can overload the liver in adults who drink too much. However, doctors have realized children can also get the disease, especially if they're obese. As much as 10 percent to 50 percent of obese kids may be affected.

"In many ways, this is an emerging disease," said Schwimmer, who is also director of the Fatty Liver Clinic at Children's Hospital in San Diego. "It's common, but there's not an awful lot known about it."

Schwimmer and his colleagues studied 100 children aged 2 to 18 who were diagnosed with nonalcoholic fatty liver disease between 1997 and 2003. The researchers reported their findings May 18 at the annual Digestive Disease Week conference in New Orleans.

There appeared to be two types of the disease, which the researchers labeled Type 1 (like that found in adults) and Type 2 (more common in children, especially those who are obese).

Type 2 was three times as likely to occur in children as Type 1, and Type 2 was also much more serious, with 15 percent to 20 percent of those affected hit by liver scarring. Advanced liver disease and cirrhosis were only found in children with Type 2. Also, Type 2 was more common in boys and in Latinos and minority children.

It's not clear if the effects of the disease in children are permanent, Schwimmer said. Scientists are still trying to figure out if the liver can regenerate itself after scarring.

Lok said the findings are important because they will let doctors develop individual treatments for the two types of disease.

She also said the research will also help physicians fine-tune their examinations of children. "It's important that doctors not look for what they would seek in adults," she said.

More information

Get more details about fatty liver disease from the Liver Foundation.

SOURCES: Jeffrey Schwimmer, M.D., assistant professor, pediatrics, University of California at San Diego, and director, Fatty Liver Clinic, Children's Hospital, San Diego; Anna Lok, M.D., professor, internal medicine, University of Michigan, Ann Arbor; May 18, 2004, presentation, Digestive Diseases Week conference, New Orleans
Consumer News