MASLD in childhood as a multisystem health challenge beyond the liver

Area of Science:

• Pediatric Endocrinology
• Hepatology
• Public Health

Background:

• Childhood obesity and type 2 diabetes are increasing, leading to a rise in pediatric metabolic dysfunction-associated steatotic liver disease (MASLD).
• MASLD presents a significant health burden beyond the liver, affecting cardiometabolic health.
• Emerging evidence highlights extrahepatic complications of pediatric MASLD, including bone health, growth, sleep, and neurobehavioral issues.

Purpose of the Study:

• To explore the multifaceted long-term health impact of childhood-onset MASLD.
• To emphasize MASLD as a multisystem disorder with significant extrahepatic consequences.
• To highlight the need for increased clinical awareness and research into MASLD mechanisms and comorbidities.

Main Methods:

• Literature review and synthesis of current evidence on pediatric MASLD.
• Analysis of emerging data on hepatic and extrahepatic complications.
• Exploration of the long-term health trajectory and psychosocial risks associated with pediatric MASLD.

Main Results:

• Pediatric MASLD is linked to impaired bone health, growth deficits, sleep disturbances, and neurobehavioral problems like depression and anxiety.
• Progression of MASLD can increase the risk of steatohepatitis, fibrosis, and potentially hepatic and extrahepatic cancers.
• Extrahepatic complications significantly impact long-term health and psychosocial well-being in affected children.

Conclusions:

• Pediatric MASLD is a multisystem disorder with profound long-term health implications.
• Early detection, enhanced clinical awareness, and coordinated multidisciplinary care are essential for improving outcomes.
• Further research into the mechanisms and comorbidities of pediatric MASLD is urgently needed.