Growing problem of growing

▸ Koebnick C, Getahun D, Reynolds K, et al. Trends in nonalcoholic fatty liver disease-related hospitalizations in US children, adolescents, and young adults. J Pediatr Gastroenterol Nutr 2009;48:597–603.

Although obesity has been a well-recognised public health problem in western countries, the impact of non-alcoholic fatty liver disease (NAFLD) on public health has not been estimated accurately. Koebnick et al identified hospitalisation discharges with NAFLD or obesity among children and young adults (6–25 years) from the 1986–2006 National Hospital Discharge Survey data. Between 1986 and 1988, and 2004 and 2006, hospitalisations with a diagnosis of NAFLD increased from 0.9 to 4.3/100 000 population (p<0.001). During the same time, hospitalisations with a diagnosis of obesity increased from 35.5 to 114.7/100 000 population (p<0.001). During 2004–2006, hospitalisation rates with a diagnosis of NAFLD were higher among females than among males (5.9 vs 2.7/100 000 population, p<0.001), as were hospitalisations with a diagnosis of obesity (140.8 vs 61.5/100 000 population, p<0.001). Obesity and diabetes were reported in 43.3% and 31.9%, respectively, of discharges with NAFLD.

Although the authors rightly conclude that the trend in NAFLD could be a consequence of the obesity epidemic or of increased screening for liver …