Pediatric MASLD in China: epidemiology, screening, diagnosis, and management

Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global epidemic, with a rapidly increasing burden among children and adolescents in China. This alarming trend is primarily driven by profound lifestyle shifts. Unlike earlier perceptions of pediatric MASLD as relatively benign, pediatric-onset MASLD is now recognized as a progressive condition associated with liver fibrosis, cirrhosis, cardiometabolic comorbidities, and elevated risks of hepatocellular carcinoma and early mortality. In China, this escalating burden is compounded by regional disparities, diagnostic challenges, and limited access to pediatric-specific screening and management tools. Yet early-life detection and intervention present a critical window to mitigate long-term liver-related and systemic health consequences. This review synthesizes the latest epidemiological data, screening strategies, diagnostic innovations, and therapeutic approaches for pediatric MASLD in the Chinese context. By integrating emerging evidence with national public health priorities, we aim to inform actionable policies and tailored intervention strategies to confront this growing epidemic.