Metabolic dysfunction-associated steatotic liver disease in children

Area of Science:

• Pediatric Gastroenterology
• Hepatology
• Metabolic Disorders

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly NAFLD, is the leading cause of pediatric chronic liver disease.
• MASLD affects 1 in 10 children and can progress to advanced fibrosis, impacting overall health.
• Comorbidities include type 2 diabetes, hypertension, dyslipidemia, and mental health issues.

Purpose of the Study:

• To review the current understanding of pediatric MASLD, including diagnosis, comorbidities, and treatment challenges.
• To highlight the need for non-invasive diagnostic tools and effective therapeutic strategies in children.
• To emphasize the role of genetics, particularly the PNPLA3 gene, in disease risk and severity.

Main Methods:

• Review of current literature on pediatric MASLD.
• Discussion of diagnostic modalities, including liver biopsy and non-invasive imaging like MRI.
• Analysis of associated comorbidities and emerging genetic factors.

Main Results:

• MASLD is prevalent in children, with a significant portion developing advanced fibrosis.
• MRI-PDFF and MRE are reliable non-invasive tools for assessing steatosis and fibrosis.
• A low-free sugar diet may reduce liver fat and inflammation markers.

Conclusions:

• Pediatric MASLD is a growing concern with serious health implications and limited treatment options.
• Urgent need for pediatric clinical trials to develop pharmacological interventions.
• Genetic factors like PNPLA3 influence disease progression, offering potential therapeutic targets.