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Experts warn that high levels of hepatic steatosis in young people, due to being overweight, could signal a potential public health crisis.
Non-alcoholic fatty liver disease is quite common in the elderly and can be detected in about a quarter of the population. One study, however, found that a significant number of 24-year-olds are also affected, exposing them to serious health problems, such as liver cancer, type 2 diabetes, and heart attacks.
Researchers at the University of Bristol have tested more than 4,000 young people enrolled in a longitudinal study entitled Children of the 90s, designed to track the life and health of children born in 1991 and 1992 in Avon, in England.
All had undergone an ultrasound scan at the age of 18, which revealed that 2.5% had non-alcoholic fatty liver disease. Five years later, a new type of CT called transient elastography or fibroscan detected that more than 20% of patients had fatty deposits on the liver, or steatosis, indicating non-alcoholic fatty liver disease. Half of these were clbadified as serious. The badyzes also revealed that 2.4% had fibrosis – scarring of the liver. Severe scarring can cause cirrhosis.
Presenting the results of the study at the International Liver Congress in Vienna, Dr. Kushala Abeysekera, of the University of Bristol, said: "We were worried to find that at the age of 24, one in five had steatosis and one in 40 had evidence of fibrosis, based on elastography results, in a group of largely asymptomatic, mainly Caucasian, young people.
"The results of our study suggest that greater public health awareness of non-alcoholic fatty liver disease is needed among young adults in the UK."
He told the Guardian that they were not expecting to see these levels of illness in young people. "Nobody had ever looked at them with fibroscan. It's a blind spot in clinical practice, "he said. "We do not look because it's unlikely that they have any complications."
They needed more data and would track the youth participating in the study, he said, but "it's potentially a omen of things to come." We can witness an increase in serious diseases of the liver at an advanced stage. This could go from the 50s and 60s to the 40s and 50s because of the epidemic. "
The vast majority of young people with non-alcoholic fatty liver disease were overweight, with a BMI greater than 25. Among those with the highest number of fatty liver deposits, 60% were obese.
The study excludes people who drink a lot, but there will be people with fatty liver because of their excess weight and excessive consumption of alcohol.
The disease is reversible if people eat well, regain normal weight, exercise and drink only moderately. That's why the public health message needs to be promoted, say the researchers. Abeysekera said the kids were unaware of the long-term risk they were running.
Philip Newsome, deputy secretary of the European Association for the Study of the Liver, said: "These data highlight the impact of the obesogenic environment and in particular its role in the development of non-alcoholic fatty liver disease in the younger segment of the population. This requires rapid changes in public policy if we want to defuse the time bomb of obesity and non-alcoholic fatty liver disease. "
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