Down Syndrome and Pediatric Nonalcoholic Fatty Liver Disease: A Causal or Casual Relationship?

The incidence of overweight/obesity in patients with Down syndrome is high. In a recent systemic review, Down syndrome was associated with varying prevalence rates of obesity (23%-70%).1 Likely determinants of obesity, in addition to short stature, were an increase in circulating leptin (a marker of leptin resistance), reduced adiponectin expression, adherence to an unfavorable diet, presence of comorbidities, gait disorder, and decreased resting energy expenditure with low levels of fitness and physical activity.

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