Pediatric MASLD: current understanding and practical approach

Anne-Sophie R Stroes1, Miriam Vos2, Marc A Benninga1

  • 1Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

PubMed

Insights

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing concern in children, linked to obesity. New criteria and emerging treatments highlight the importance of early identification and management of this liver condition.

Area of Science:

  • Pediatric Gastroenterology and Hepatology
  • Metabolic Disorders
  • Public Health

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading chronic liver disease in children globally, driven by increasing obesity rates.
  • MASLD is associated with significant risks, including progressive liver damage, type 2 diabetes mellitus, and cardiovascular disease.
  • Current challenges include underdiagnosis due to low awareness and the absence of straightforward diagnostic criteria.

Purpose of the Study:

  • To review the epidemiology and risk factors of pediatric MASLD.
  • To provide an evidence-based approach for screening, diagnosis, and treatment of MASLD in children.
  • To highlight recent advancements in diagnostic criteria and emerging therapeutic options.

Main Methods:

  • Literature review of current evidence and expert opinion on pediatric MASLD.
  • Analysis of epidemiological data and risk factors.
  • Synthesis of updated diagnostic guidelines and treatment strategies.

Main Results:

  • MASLD is strongly associated with childhood obesity, overweight, and insulin resistance.
  • New diagnostic criteria simplify the identification of MASLD, shifting it from a diagnosis of exclusion to a positive diagnosis.
  • Emerging effective treatments for adults suggest potential future therapies for children.

Conclusions:

  • Early identification of pediatric MASLD is crucial, especially with new diagnostic tools and potential treatments on the horizon.
  • A proactive approach to screening, diagnosis, and management is needed to address the rising prevalence of MASLD.
  • Further research is warranted to optimize treatment strategies for children with MASLD.

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