As Prescribed: Fatty liver disease on the rise among a surprising population

SAN FRANCISCO (KCBS RADIO) – The illness once known as fatty liver disease is on the rise among a surprising population -- children -- and is now estimated to be as common as pediatric asthma.

"We've been seeing younger and younger kids come in not only with steatosis or fat in the liver, but also with steatohepatitis, so that's that inflammation in the liver, as well as fibrosis, which is that scar tissue -- which is really scary to think if you're six or eight years old coming in and already have scar tissue from the fat in the liver," Dr. Sarah Maxwell, a pediatrician currently completing her pediatric transplant hepatology fellowship at UCSF Benioff Children's Hospitals, told KCBS Radio's Patti Reising on this week's "As Prescribed."

Non-alcoholic fatty liver disease, which was recently renamed metabolic dysfunction associated steatotic liver disease (MASLD), is a condition where excess fat builds up in the liver. The condition is marked by pain, fatigue and jaundice, can lead to cirrhosis and cancer, and is the number one indicator for a liver transplant as an adult.

According to a new UCSF study led by Maxwell, Latinx kids with food insecurity who do not have access to regular meals at the age of four are four times more likely to have MASLD. Dr. Maxwell said researchers are still trying to figure out exactly how food insecurity leads to MASLD.

"There's a lack of consistent quality and quantity of food, of healthy and nutritious food in the household," she said. "Having less access to healthy fruits and vegetables, people might be replacing that with more, more soda and more processed foods."

Household food insecurity can also cause irregular eating patterns that can change stress hormones and affect how the microbiome actually works.

"Often parents will try to protect their children and they will sometimes not even eat themselves in order to provide the best food for their children. And even this more mild form of food insecurity, we found this very strong association," Dr. Maxwell explained. "They also might have intermittent periods of fasting or starvation and overconsumption, and that might change how their body regulates and processes and stores fat as well as glucose."

As for why Latinx children seem to be more commonly affected, Maxwell said research is ongoing but there are clearly "significant disparities."

"Latinx, especially those of Mexican and Central Americans, especially those who are boys, have some of the highest rates for MASLD. And there have been a few single nucleotide polymorphisms -- so, some genetic mutations that have been identified as being more common in people of Mexican and Central American origins that somewhat are associated with MASLD," she said.

While MASLD is often associated with obesity, children who have the condition may not show any symptoms.

"Really, there are no symptoms until the disease has progressed and you have pretty significant scar tissue and damage in the liver," Dr. Maxwell said. "And that's one of the really most important things is to try to spread awareness and get both pediatricians to start screening and families to be more aware."

Listen to this week's "As Prescribed" to learn more. You can also listen to last week's episode to learn how UCSF researchers are using an app to help patients dealing with dementia, here .

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"As Prescribed" is sponsored by UCSF.