The rising prevalence of obesity among children is significantly increasing the number of pediatric liver fat cases in South Korea.
As childhood obesity has surged, South Korea has seen a notable rise in cases of fatty liver disease among children, particularly those under 10 years old. Dr. Ryu In-hyuk from Catholic University's Seoul St. Mary's Hospital indicates that fatty liver is no longer uncommon in children over the age of 10 and is increasingly being found in younger children, including those aged 8 to 9 years. The relationship between obesity and fatty liver is complex; while obesity leads to increased fat storage in the liver, the condition also induces the liver to secrete abnormal signaling molecules that exacerbate insulin resistance within muscles and fat tissues, leading to a feedback loop that complicates blood sugar regulation and further accumulates liver fat.
Globally, it is estimated that between 7% and 14% of children and adolescents suffer from liver fat, a figure that spikes to between 30% and 50% among obese children. This trend is mirrored in South Korea, where over 40% of obese children are found to have fatty liver, with figures reportedly rising above 50% post-COVID-19, a period during which physical activity declined and the consumption of take-out and ultra-processed foods increased, adversely affecting children's liver health. Fatty liver disease is indicative of broader systemic metabolic issues and the global liver community has reclassified it from 'non-alcoholic fatty liver disease (NAFLD)' to 'metabolic dysfunction-associated fatty liver disease (MASLD)', shifting the focus to its significant link with metabolic dysfunction rather than viewing it as a condition isolated to the liver.
MASLD encompasses a spectrum ranging from simple fat accumulation in the liver to more severe conditions like liver inflammation (MASH), fibrosis, and cirrhosis. Diagnosis no longer rests on liver enzyme levels alone but now includes a comprehensive assessment of metabolic health indicators like obesity, blood sugar levels, hypertension, and high triglycerides. This shift in understanding emphasizes that fatty liver disease is not merely a liver issue but rather a metabolic disease that reflects the overall health of the body's metabolic system.
