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FISPGHAN statement on the global public health impact of metabolic dysfunction-associated steatotic liver disease
Tania Mitsinikos1,2, Marion M Aw3,4, Robert Bandsma5
1Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, Los Angeles, California, USA.
Insights
Metabolic dysfunction-associated steatotic liver disease (MASLD) is rising globally, particularly in pediatrics. This review outlines evidence-based actions for MASLD prevention and management, addressing individual and public health strategies.
Area of Science:
- Pediatric Gastroenterology, Hepatology, and Nutrition
- Public Health
- Epidemiology
Background:
- Global obesity rates are increasing, leading to a rise in metabolic dysfunction-associated steatotic liver disease (MASLD), formerly nonalcoholic fatty liver disease.
- MASLD presents a growing burden on healthcare systems, necessitating urgent global attention.
- The Federation of International Societies for Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN) prioritized MASLD as a critical area for expert review.
Purpose of the Study:
- To describe feasible, evidence-based actions for reducing MASLD risk in pediatric populations.
- To review the epidemiology, natural history, screening, and management of MASLD.
- To explore public health measures for MASLD prevention, including risk factor reduction and lifestyle support.
Main Methods:
- Expert team convened by FISPGHAN to address MASLD epidemiology, treatment, and prevention.
- Subtopics selected through expert consensus.
- Comprehensive review of existing literature on MASLD, public health interventions, and pediatric health.
Main Results:
- MASLD incidence is increasing worldwide, with significant implications for pediatric health.
- Effective prevention and management strategies require a multi-faceted approach, integrating individual patient care with public health initiatives.
- Interventions targeting environmental, iatrogenic, maternal, and newborn health, alongside promoting healthy lifestyles, are crucial for risk reduction.
Conclusions:
- Addressing the rising burden of MASLD in pediatrics requires a coordinated global effort.
- Evidence-based strategies encompassing screening, management, and prevention are essential.
- Public health policies and individual-level interventions play a vital role in mitigating MASLD risk.
Abstract:
As rates of obesity rise worldwide, incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly referred to as nonalcoholic fatty liver disease, is increasing, worsening the burden of healthcare systems. The council of the Federation of International Societies for Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN) identified the topic of MASLD epidemiology, treatment, and prevention as a global priority issue to be addressed by an expert team, with the goal to describe feasible and evidence-based actions that may contribute to reducing MASLD risk. The FISPGHAN member societies nominated experts in the field. The FISPGHAN council selected and appointed members of the expert team and a chair. The subtopics included in this manuscript were chosen through a consensus of the experts involved. We review the epidemiology, natural history, and screening and management. We further expand to relevant public health measures aimed at MASLD prevention, including identifying interventions that could reduce risk factors (environmental and iatrogenic), optimize maternal and newborn health, and support healthier lifestyles for older children and adolescents on a local, national, and international scale. While recognizing that various aspects of population health and public policy can shape MASLD risk, we also review what we can do on an individual level to support our patients to reduce the significant burden of this ever rising disease in pediatrics.
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