Prevalence of Non-alcoholic Fatty Liver Disease (NAFLD) among Children and Adolescents (<18 years) in India: A Systematic Review and Meta-analysis
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Background
Non-alcoholic fatty liver disease (NAFLD) has become a common metabolic disorder in paediatric age groups and is a major contributor to the burden of health economics. However, there is a lack of comprehensive data on the prevalence of this condition among children.
Methods
English language literature published from inception until April 2025 was searched from the electronic databases, i.e., PubMed/Medline, Scopus, Embase, and CINAHL. Original data published in any form that reported NAFLD prevalence among children and/or adolescent population from India were included. The subgroup analysis of prevalence was done based on the risk category, i.e., average-risk group, and high-risk group (obesity or overweight, metabolic syndrome, etc.). The prevalence estimates were pooled using the random-effects model.
Results
A total of 11 studies (six in high-risk populations and 5 in the average-risk general population) comprising data from 3512 individuals were found eligible and were included. The overall pooled estimate of NAFLD prevalence among the children and adolescents was 35.4% (95% CI: 19.7%–52.9%) with very high heterogeneity(I 2 =99.0%). The pooled prevalence of NAFLD among average/low risk children and adolescents was 10.7% (95%CI: 5.2% to 20.5%) with high heterogeneity across the studies (I 2 = 96.6%, p=0.001) whereas the pooled prevalence of NAFLD in high risk overweight/obese children and adolescents was found to be 59.7% (95% CI:55.2% to 64.1%) with moderate heterogeneity across the studies (I 2 =50.90%; H 2 =2.04; Q (5) = 10.03; p=0.07)
Conclusion
This systematic review demonstrates that non-alcoholic fatty liver disease (NAFLD) poses a growing health concern among Indian children and adolescents, as 1 out of 3 children/adolescents are suffering from it, with a disproportionately high burden observed in those who are overweight or obese.
