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With the growing obesity epidemic, NAFLD is now believed to be the most common liver disease worldwide, affecting up to 13 percent of children and one-third of adults. NASH affects 2-3 percent of all adults and children, but is found in approximately 25 percent of children who have fatty liver. Up to one-quarter of patients with NASH may go on to more severe fibrosis, cirrhosis and end-stage liver disease. The majority of patients with pediatric NAFLD or NASH are overweight or obese, and many have associated health problems, such as insulin resistance, diabetes mellitus, obstructive sleep apnea, hypertension and dyslipidemia (features of metabolic syndrome).
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