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Defining paediatric metabolic (dysfunction)-associated fatty liver disease: an international expert consensus
Mohammed Eslam1, Naim Alkhouri2, Pietro Vajro3
1Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney, NSW, Australia.
The current definition of non-alcoholic fatty liver disease (NAFLD) is inadequate for children. A new framework and age-appropriate definition for metabolic (dysfunction)-associated fatty liver disease (MAFLD) are proposed for improved pediatric care.
Area of Science:
- Hepatology
- Pediatric Gastroenterology
- Metabolic Disorders
Background:
- Non-alcoholic fatty liver disease (NAFLD) definitions present challenges, particularly for pediatric populations where alcohol consumption is not a factor.
- Existing NAFLD definitions are problematic for children, necessitating a re-evaluation for accurate diagnosis and care.
- Metabolic (dysfunction)-associated fatty liver disease (MAFLD) has been proposed as a new definition for adults with metabolic dysregulation.
Purpose of the Study:
- To propose an overarching framework for pediatric fatty liver diseases.
- To introduce an age-appropriate definition for metabolic (dysfunction)-associated fatty liver disease (MAFLD) in children.
- To provide a conceptual scaffold for diagnosis, risk stratification, and multidisciplinary care of pediatric fatty liver diseases.
Main Methods:
- An international panel reviewed existing definitions and proposed a new framework.
- Development of age- and sex-percentile-based diagnostic criteria for pediatric MAFLD.
- Consideration of coexisting systemic fatty liver diseases in children within the proposed framework.
Main Results:
- The proposed framework acknowledges the complexities of fatty liver diseases in children.
- New MAFLD diagnostic criteria are presented, tailored for pediatric populations.
- The revised definition aims for consistency and validity across all age groups.
Conclusions:
- The proposed MAFLD definition and framework offer a more accurate and clinically useful approach for pediatric fatty liver disease.
- These advancements support improved diagnosis, risk stratification, and comprehensive care for children.
- The new definition aligns with a lifespan approach to fatty liver disease management.
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