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Diagnosis and Management of Pediatric Non-Alcoholic Fatty Liver Disease: An Overview
Dalia Dop1, Vlad Pădureanu2, Rodica Pădureanu2
1Department of Pediatrics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Insights
Non-alcoholic fatty liver disease (NAFLD) is a growing global health issue in children, often linked to obesity. Current treatments focus on lifestyle changes, as effective pediatric medications and fibrosis biomarkers are still lacking.
Area of Science:
- Pediatric Hepatology
- Metabolic Disorders
- Public Health
Background:
- Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver condition in children globally.
- Its incidence is rising due to increased childhood obesity and sedentary behaviors.
- The complex pathogenesis involving genetic, intrauterine, and environmental factors remains incompletely understood.
Purpose of the Study:
- To summarize the current understanding of pediatric NAFLD.
- To highlight the challenges in diagnosis and treatment.
- To emphasize the need for further research and validated therapies.
Main Methods:
- Review of current literature on pediatric NAFLD.
- Analysis of epidemiological trends and risk factors.
- Assessment of existing diagnostic and therapeutic strategies.
Main Results:
- Pediatric NAFLD is often asymptomatic, diagnosed incidentally in overweight/obese children.
- Associated metabolic complications can lead to cirrhosis and hepatocellular carcinoma.
- Current management relies on lifestyle modifications; no approved pharmacotherapy exists for children.
Conclusions:
- There is an urgent need for validated non-invasive fibrosis biomarkers and approved pharmacological treatments for pediatric NAFLD.
- Further research, including large prospective pediatric cohorts and Phase III trials, is essential.
- Long-term outcome data for children with NAFLD are scarce, necessitating further investigation.
Abstract:
Non-alcoholic fatty liver disease (NAFLD) is the most common pediatric chronic liver disease worldwide, with an increasing prevalence, mainly due to the increase in childhood obesity and sedentary lifestyle. The pathogenesis of NAFLD is multifactorial, but the mechanisms by which the factors involved, namely the genetic, intrauterine and environmental factors responsible for its onset and progression to NASH, are not fully known. Children with NAFLD are usually asymptomatic or show nonspecific symptoms, and NAFLD is generally diagnosed incidentally by screening tests in overweight or obese children. NAFLD is associated with severe metabolic deficiencies that may progress to cirrhosis and hepatocellular carcinoma, with the consequent need for liver transplantation. Current treatment of NAFLD in children consists of lifestyle changes to decrease caloric intake and increase physical activity, with no currently approved pharmacological medication for the pediatric population. Although pediatric studies that focus on alternative treatments targeting key pathogenic factors are promising, no pharmacological agent is currently approved for children, validated non-invasive fibrosis biomarkers remain limited, and long-term outcome data are scarce. Further validation through large prospective pediatric cohorts and phase III trials is urgently needed.
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