Epidemiological features of pediatric nonalcoholic fatty liver disease in China

Objective: Non-alcoholic fatty-liver disease (NAFLD) among children and adolescents in China has emerged as a significant public-health concern, that requires greater attention. This study aims to estimate the prevalence of pediatric NAFLD and its epidemiological characteristics. Methods: Four English-language and two Chinese-language databases were systematically searched for relevant articles published before January 1st, 2025. Rigorous inclusion and exclusion criteria were applied to screen articles and extract NAFLD prevalence data. The pooled overall prevalence of NAFLD with 95% confidence intervals (CIs) was calculated using the Freeman-Tukey Double Arcsine Transformation Method. Moreover, subgroup analysis was conducted to compare NAFLD prevalence across different categories, including region, income, age, and gender. Results: The study encompassed 126,682 participants from 219 studies. The nationwide prevalence of pediatric NAFLD in China was 22.82%. Higher prevalence rates were observed among boy, older age groups, individuals in southern and northeastern regions, and those classified as obese or overweight. Furthermore, epidemiological pattern analysis of children with NAFLD identified metabolic, endocrine, and lifestyle factors as crucial determinants in pediatric NAFLD progression. Conclusions: Considering the substantial burden of pediatric NAFLD in China, researchers must conduct effective intervention studies to address its epidemiological status. Additionally, governmental action is required to enhance public awareness and establish health policies aimed at controlling the NAFLD epidemic among Chinese children. Trial registration : The registration number was CRD42020206731.