Author(s): ,
Oyekoya Taiwo Ayonrinde
School of Medicine and Pharmacology,The University of Western Australia,Nedlands,Australia;Gastroenterology and Hepatology,Fiona Stanley Hospital,Murdoch,Australia
Wendy H Oddy
Telethon Kids Institute,The University of Western Australia,Perth,Australia
Leon A Adams
School of Medicine and Pharmacology,The University of Western Australia,Nedlands,Australia
Trevor A Mori
School of Medicine and Pharmacology,The University of Western Australia,Perth,Australia
Lawrence Beilin
School of Medicine and Pharmacology,The University of Western Australia,Perth,Australia
John K Olynyk
Gastroenterology and Hepatology,Fiona Stanley Hospital,Murdoch,Australia
EASL LiverTree™. Ayonrinde O. Apr 15, 2016; 125715; FRI-321 Topic: Non-alcoholic fatty liver disease
Disclosure(s): Nil
Dr. Oyekoya Ayonrinde
Dr. Oyekoya Ayonrinde

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Topic: Clinical

Background and aims
Nonalcoholic fatty liver disease (NAFLD) in adolescents may have its origins in adiposity gains and nutrition established during childhood. There is a paucity of data regarding the influence of infant nutrition and maternal factors on NAFLD in adolescence.We examined the association of infant nutrition on the subsequent diagnosis of NAFLD at age 17 years in a well-characterised longitudinal pregnancy and birth cohort.

Longitudinally collected data on participants in the cohort study were analysed for associations between maternal pre-pregnancy and pregnancy characteristics, early life  nutrition and subsequent NAFLD. Data included birth, childhood and adolescent characteristics obtained by questionnaires, direct interview, physical examination, blood tests and liver ultrasound. Fatty liver was diagnosed with liver ultrasound. 

1170 adolescents aged 17 years had liver ultrasound. NAFLD was diagnosed in 15.2% of the cohort, predominantly female. Birth anthropometry was not associated with NAFLD. Most (94%) of neonates were breastfeeding on leaving hospital. Neonates discharged from hospital breastfeeding had a higher likelihood of still breastfeeding at 6 months when compared with neonates discharged bottle-feeding (59% vs. 3%, p<0.001). There was a lower prevalence of adolescent NAFLD in neonates discharged home breastfeeding vs. bottle feeding (14.6% vs. 24.3%, p=0.03) and in infants exclusively breastfeeding for ≥6months vs. <6months (11.3% vs. 17.8%, p=0.003). There was no difference in the proportion of infants subsequently diagnosed with NAFLD in association with the type of milk consumed at age 1 year, age at introduction of solid foods or maternal age or smoking. Normal range maternal body mass index pre-pregnancy (OR 0.49, 95%CI 0.33-0.72, p<0.001) and exclusive breastfeeding for ≥6months (OR 0.66, 95%CI 0.56-0.95, p<0.03) were associated with a lower risk of adolescent NAFLD. Breastfeeding beyond 9 months did not further reduce the odds of NAFLD during adolescence (OR 0.73, 95% CI 0.46-1.16, P=0.18). 

Normal range BMI at the start of pregnancy and exclusive breast milk feeding for at least the first 6 months of life may reduce the odds of NAFLD in adolescent offspring by half and one third respectively. These findings suggest a potential benefit of exclusive breastfeeding for ≥ 6 months to reduce the odds of a NAFLD diagnosis during adolescence. Other modifiable maternal factors, including obesity, are also associated with NAFLD in adolescents.

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