Screening Patterns of Nonalcoholic Fatty Liver Disease in Children with Obesity in Canadian Primary Care: A Cross-Sectional Study
Table 2
Comparison of eligible patients aged 9–18 years screened and not screened for NAFLD in the last year.
Characteristics
Screening in the last year
No, n (%) (N = 9029)
Yes, n (%) (N = 859)
Unadjusted odds ratio (95% CI)
Adjusted odds ratio† (95% CI)
Age, years
9–12
3747 (41.5)
220 (25.6)
Ref
Ref
13–18
5282 (58.5)
639 (74.4)
2.06 (1.76–2.41)
1.63 (1.38–1.93)
Sex
Male
5056 (56.0)
409 (47.6)
Ref
Ref
Female
3973 (44.0)
450 (52.4)
1.4 (1.22–1.61)
1.32 (1.14–1.54)
Location
Rural
1757 (19.8)
130 (15.6)
Ref
Ref
Urban
7099 (80.2)
704 (84.4)
1.34 (1.1–1.63)
1.37 (1.12–1.67)
Missing
173
25
BMI, percentile
≥95th–<99th (obese)
7049 (78.1)
609 (70.9)
Ref
Ref
≥99th (severe obesity)
1980 (21.9)
250 (29.1)
1.46 (1.25–1.71)
1.36 (1.15–1.60)
Preexisting conditions‡
Diabetes
63 (0.70)
27 (3.1)
4.62 (2.93–7.29)
1.56 (0.87–2.80)
Hypertension
173 (1.9)
42 (4.9)
2.63 (1.87–3.72)
1.35 (0.89–2.04)
Dyslipidemia
218 (2.4)
54 (6.3)
2.71 (1.99–3.67)
0.99 (0.70–1.42)
Depression/Anxiety
521 (5.8)
81 (9.4)
2.58 (2.08–3.19)
1.20 (0.91–1.57)
PCOS
17 (0.19)
7 (0.81)
4.36 (1.80–10.53)
1.41 (0.51–3.93)
Prior medications‡
Antipsychotics
233 (2.5)
49 (5.7)
2.39 (1.74–3.28)
1.09 (0.74–1.60)
Anxiolytics
148 (1.6)
40 (4.7)
2.93 (2.05–4.19)
1.99 (1.34–2.97)
Antidepressants
970 (10.7)
177 (20.6)
2.16 (1.80–2.58)
1.14 (0.91–1.44)
Antihypertensives
111 (1.2)
16 (1.9)
1.52 (0.89–2.59)
0.65 (0.34–1.28)
Antidiabetics
36 (0.40)
26 (3.0)
7.80 (4.69–12.99)
2.88 (1.54–5.38)
Prior liver panel‡
AST and/or ALT
1338 (14.8)
347 (40.4)
3.90 (3.36–4.52)
2.94 (2.49–3.48)
Prior primary healthcare utilization 1 year average
3.82 (3.8)§
5.6 (5.3)§
1.08 (1.07–1.10)
1.02 (1.01–1.04)
Prior specialist referral‡
Gastroenterology
67 (0.74)
18 (2.1)
2.87 (1.69–4.84)
1.53 (0.88–2.69)
Endocrinology
96 (1.1)
23 (2.7)
2.56 (1.63–4.06)
1.13 (0.68–1.88)
Pediatrics
1154 (12.8)
142 (16.5)
1.35 (1.12–1.63)
1.11 (0.90–1.36)
† Multivariate logistic regression (fully adjusted) model; ‡yes vs no (reference); §reported as mean (standard deviation); BMI, body mass index; PCOS; polycystic ovarian syndrome; AST, aspartate aminotransferase; ALT, alanine transaminase.