Pediatric liver disease increases risk of developing type 2
This study included 892 children with NAFLD and with a mean age of 12.8 (2.7) years followed for 3.8 (2.3) years with a total 3,234 person-years at risk. The incidence rate of T2D was 3,000 new cases per 100,000 person-years at risk. At baseline, 63 children had T2D, and during follow-up, an additional 97 children developed incident T2D, resulting in a period prevalence of 16.8 %. Incident T2D was significantly higher in females versus males (HR 1.8 [1.0-2.8]), associated with BMI z-score (HR 1.8 [1.0-3.0]), and more severe liver histology including steatosis grade (HR 1.3 [ 1.0-1.7]), and fibrosis stage (HR 1.3 [1.0-1.5]).

Children with NAFLD are at high risk for existing and incident T2D. In addition to known risk factors for T2D (females and BMI z-score), severity of liver histology at the time of NAFLD diagnosis was independently associated with T2D development. Targeted strategies to prevent T2D in children with NAFLD are needed.