Screening and diagnosis of metabolic dysfunction-associated steatotic liver disease in children within public healthcare
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
View abstract on PubMed
Summary
This summary is machine-generated.Metabolic dysfunction-associated steatotic liver disease (MASLD) screening in children largely follows guidelines, but many cases go unrecognized. Further research is needed to optimize screening protocols and address potential underdiagnosis.
Area Of Science
- Pediatric Gastroenterology and Hepatology
- Public Health and Epidemiology
- Clinical Implementation Science
Background
- Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence is rapidly increasing in children.
- Current NASPGHAN guidelines recommend screening at-risk children for MASLD, yet implementation details require exploration.
- Understanding screening practices is crucial for effective MASLD management in pediatric populations.
Purpose Of The Study
- To evaluate the implementation of MASLD screening practices in a large cohort of children investigated for overweight/obesity.
- To assess adherence to NASPGHAN screening recommendations and identify areas for improvement.
- To investigate diagnostic yields and potential secular trends in MASLD screening.
Main Methods
- Retrospective analysis of data from 908 children (median age 11.4 years) evaluated for overweight/obesity.
- Examination of screening methods used, including alanine aminotransferase (ALT) testing and ultrasonography.
- Application of novel criteria for retrospective MASLD diagnosis and assessment of metabolic comorbidities and differential diagnostics.
Main Results
- Screening was performed in 86.2% of eligible children and 69.3% of ineligible younger children, indicating broad but sometimes excessive application.
- Alanine aminotransferase (ALT) testing increased significantly over time (2002-2020), particularly in tertiary care.
- While 7.4% of children were diagnosed clinically, 14.5% met criteria retrospectively, suggesting potential underdiagnosis of MASLD.
Conclusions
- Current MASLD screening practices in children are largely consistent with recommendations, showing good acceptance.
- Despite high screening rates, a significant proportion of MASLD cases may be underdiagnosed, highlighting the need for refined diagnostic criteria.
- The study suggests a need for updated guidelines, particularly regarding optimal age thresholds for screening in younger children.
These videos have been matched automatically. Contact us if they are not relevant.
These videos have been matched automatically. Contact us if they are not relevant.
Related Concept Videos
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
Endoscopic Ultrasound (EUS) and FibroScan are valuable diagnostic tools in gastroenterology and hepatology, each with specific applications and techniques.
Endoscopic Ultrasound (EUS):
Technological Integration: EUS is a sophisticated integration of optical endoscopy and ultrasonography. The endoscope visualizes the mucosal surface directly, while the ultrasound component penetrates deeper to visualize organs and structures beyond the gastrointestinal wall.
Image Formation: The ultrasound...
Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...