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Current Concepts in Pediatric Nonalcoholic Fatty Liver Disease
Sarah E Fleet1, Jay H Lefkowitch2, Joel E Lavine3
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Columbia University Medical Center, 622 West 168th Street, PH17-119, New York, NY 10032, USA.
Abstract:
Nonalcoholic fatty liver disease (NAFLD) represents a spectrum of disease. Its increasing prevalence is a direct result of historically high rates of obesity. Hepatocyte lipid accumulation is the first step in a cascade of metabolic and inflammatory events thought to precipitate NAFLD. Histologic findings provide insight into these events. Lifestyle modification remains the primary therapy in children. Current recommendations include vitamin E treatment in those with biopsy-proven NASH. Trials of novel drugs are ongoing in adults. As efficacy/safety are established, these therapies may be tenable for use in children. At the current time, biopsy-driven histology endpoints are necessary to establish whether future therapies can improve pediatric or adult-type NASH in children.
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