There is a lower prevalence and severity of nonalcoholic fatty liver disease (NAFLD) in black children compared with the general obese pediatric population, according to a recent autopsy study in New York City. Liver specimens were examined from children aged 2-19 years who died of unexpected causes within 48 hours of medical presentation and underwent autopsy in New York City from 2005 to 2010. Records were reviewed for age, sex, weight, height, and race. 2 hepatopathologists evaluated each liver specimen to determine pathologic diagnosis. They found:

• The final study cohort (n=582) was 50% black, 33% Hispanic, 12% white, 3% Asian, and 2% other; 36% had a body mass index >85%.
• There were 26 cases of NAFLD (4.5%) of which 10 had nonalcoholic steatohepatitis (1.7%).
• There were no cases with severe fibrosis or cirrhosis.
• 1% (3/290) of black children had NAFLD and none had nonalcoholic steatohepatitis.
• White and Hispanic children had the highest percentages of NAFLD at 8.3% and 7.9%, respectively.