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The Progression and Natural History of Pediatric Nonalcoholic Fatty Liver Disease
Nidhi P Goyal1, Jeffrey B Schwimmer1
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, San Diego, San Diego, CA, USA; Department of Gastroenterology, Rady Children's Hospital, San Diego, CA, USA.
Insights
Nonalcoholic fatty liver disease (NAFLD) in children is a growing concern, linked to serious health issues like heart problems and increased cancer risk later in life. Early diagnosis and monitoring are crucial for understanding and managing pediatric NAFLD outcomes.
Area of Science:
- Hepatology
- Pediatric Gastroenterology
- Public Health
Background:
- Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in the United States.
- Pediatric NAFLD is associated with significant hepatic and nonhepatic morbidity and mortality.
- Nonhepatic complications encompass cardiovascular, metabolic, pulmonary, and psychological disorders.
Purpose of the Study:
- To highlight the multifaceted health risks associated with childhood NAFLD.
- To emphasize the need for structured diagnosis and follow-up in pediatric NAFLD.
- To improve the understanding of long-term outcomes in children with NAFLD.
Main Methods:
- Review of existing literature on childhood NAFLD and its associated morbidities.
- Analysis of nonhepatic associations, including cardiovascular conditions like left ventricular dysfunction.
- Exploration of potential in utero origins in offspring of diabetic mothers.
Main Results:
- Childhood NAFLD is linked to increased odds of adult hepatocellular carcinoma.
- Cardiovascular issues, such as left ventricular dysfunction, are observed in affected children.
- NAFLD may originate prenatally in infants of diabetic mothers.
Conclusions:
- Pediatric NAFLD presents a complex health challenge with widespread systemic implications.
- Rigorous diagnostic and follow-up protocols are essential for pediatric NAFLD management.
- Further research is needed to fully elucidate the long-term consequences of childhood NAFLD.
Abstract:
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in the United States. Childhood NAFLD is associated with hepatic and nonhepatic morbidity and mortality. Nonhepatic associations include cardiovascular, metabolic, pulmonary, and psychological disorders. Cardiovascular conditions observed in childhood include left ventricular dysfunction. Furthermore, childhood obesity is associated with greater odds of having hepatocellular carcinoma as an adult. Evidence suggests that NAFLD may begin in utero in children of diabetic mothers. Thus rigorous efforts for structured diagnosis and follow-up are a priority to better develop the understanding of outcomes in pediatric NAFLD.
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