A new plague for obese adolescents: liver disease

Associated Press | 11/25/2008, 3:45 a.m.

TRENTON, N.J. — In a disturbing twist on the obesity epidemic, some overweight teenagers have severe liver damage caused by too much body fat, and a handful have needed liver transplants.

Many more may need a new liver by their 30s or 40s, say experts warning that pediatricians need to be more vigilant. The condition, which can lead to cirrhosis and liver failure or liver cancer, is being seen in children in the United States, Europe, Australia and even some developing countries, according to doctors and a surge of recent medical studies.

The American Liver Foundation and other experts estimate 2 percent to 5 percent of American children over age 5, nearly all of them obese or overweight, have the condition, called nonalcoholic fatty liver disease.

“It’s clearly the most common cause of liver disease,” said Dr. Ronald Sokol, head of public policy at the liver foundation and a liver specialist at Children’s Hospital and University of Colorado-Denver.

Some experts think as many as 10 percent of all children and half of those who are obese may suffer from it, but note that few are given the simple blood test that can signal its presence. A biopsy is the only sure way to diagnose this disease.

As fat builds up, the liver can become inflamed and scarred over time, leading to cirrhosis, which in years past was mostly caused by hepatitis or drinking too much alcohol. Liver failure or liver cancer can follow, but if cirrhosis has not yet developed, fatty liver disease can be reversed through weight loss.

The disease is most common in overweight children with belly fat and certain warning signs, like diabetes, cholesterol issues or heart problems. However, it’s been seen in a few children of normal weight.

Genetics, diet and exercise level are all factors. It is most prevalent among Hispanics, relatively rare among African Americans, and more common among boys than girls.

Experts blame obesity, with about two-thirds of all Americans overweight. With fatty liver disease becoming more common in adults, many experts predict it will become the top cause of liver transplants by 2020.

“There aren’t enough livers to go around,” says Dr. Philip Rosenthal of the University of California-San Francisco Children’s Hospital.

His patient, Irving Shaffino, a 15-year-old Mexican American who lives outside Lubbock, Texas, was lucky to get a transplant a year ago. He was in end-stage cirrhosis and, at 5-feet-4-1/2-inches tall, weighed 180 pounds.

Irving had been fat since age 6, thanks to a high-starch, high-fat diet of Mexican food, pizza and burgers, said his mother, Guadelupe Shaffino. At age 8, she said, he had a distended stomach and by his early teens, breathing problems kept him tethered to an oxygen tank at home.

Without health insurance, the family couldn’t find a local hospital that would do a transplant.

“My son begged me, ‘Don’t let me die, Mommy,’ so I did everything in my power to find a place to help him,” said Guadelupe Shaffino, a restaurant cook. “Thanks be to God, we found a way.”