Background. Nonalcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease, and children with a body mass index (BMI) ≥95th percentile are recommended to be screened for NAFLD by liver enzymes. Objectives. This study aimed to determine the frequency and predictors of screening for NAFLD among children with obesity in Canada and to evaluate a sample of children with suspected NAFLD. Methods. This cross-sectional study used data from the Canadian Primary Care Sentinel Surveillance Network, a repository of electronic medical record data from Canadian primary care practices. Results. Of n = 110,827 children aged 9–18 years, 13.9% (n = 9,888) had a BMI ≥95^th percentile. Only 8.7% (n = 859) of these patients were screened for NAFLD in the last year, and 23.6% (n = 2336) were ever screened. Using logistic regression, screening in the last year was associated with demographic and clinical characteristics, including previous liver enzyme assessment, prior antidiabetic prescription, and prior anxiolytic prescription. Among children with suspected NAFLD (n = 1,046), 34.7% had a BMI ≥99^th percentile and approximately 8% were at increased risk of significant liver disease. Conclusion. The study revealed low screening rates for NAFLD in Canadian primary care and highlighted the important role of primary care providers in identifying and managing pediatric NAFLD.

中文翻译：

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加拿大初级保健中肥胖儿童非酒精性脂肪肝的筛查模式：横断面研究

背景。非酒精性脂肪性肝病（NAFLD）是最常见的儿童慢性肝病，建议体重指数（BMI）≥95%的儿童通过肝酶筛查是否患有NAFLD。目标。本研究旨在确定加拿大肥胖儿童中 NAFLD 筛查的频率和预测因素，并评估疑似 NAFLD 儿童样本。方法。这项横断面研究使用了加拿大初级保健哨兵监测网络的数据，该网络是加拿大初级保健实践的电子病历数据存储库。结果。在n  = 110,827 名 9-18 岁儿童中，13.9% ( n  = 9,888) 的 BMI ≥ 95 ^%。这些患者中只有 8.7% ( n  = 859) 在去年接受过 NAFLD 筛查，23.6% ( n  = 2336) 曾经接受过筛查。使用逻辑回归，去年的筛查与人口统计学和临床​​特征相关，包括既往肝酶评估、既往抗糖尿病处方和既往抗焦虑处方。在疑似 NAFLD 的儿童中（n  = 1,046），34.7% 的 BMI ≥第 99^个百分位数，约 8% 的儿童患严重肝脏疾病的风险增加。结论。该研究揭示了加拿大初级保健中 NAFLD 的筛查率较低，并强调了初级保健提供者在识别和管理儿科 NAFLD 方面的重要作用。