A Review of the Increasing Prevalence of Metabolic-Associated Fatty Liver Disease (MAFLD) in Children and Adolescents Worldwide and in Mexico and the Implications for Public Health

Ramírez-Mejía, Mariana M; Díaz-Orozco, Luis E.; Barranco-Fragoso, Beatriz; Méndez-Sánchez, Nahúm

doi:10.12659/msm.934134

Cited by 16 publications

(21 citation statements)

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“…In fact, NAFLD has been shown to be associated with IR independently of the degree of obesity, and its prevalence has been found to be increased with the increase in both MetS and T2D [5,6]. Noteworthy, the close association of fatty liver with metabolic derangements has been recently emphasized in the new nomenclature of NAFLD as metabolic (dysfunction) associated fatty liver disease (MAFLD) [7,8]. However, some controversy on the effectiveness of this new definition in children with obesity has been reported [9].…”

Section: Introductionmentioning

confidence: 99%

Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity

et al. 2021

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Background: Owing to the increasing rate of pediatric obesity, its complications such as non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) have become prevalent already in childhood. We aimed to assess the relationship between these two diseases in a cohort of children with obesity. Methods: We enrolled 153 children with obesity (mean age 10.5 ± 2.66, mean BMI 30.9 ± 5.1) showing OSA. Subjects underwent a laboratory evaluation, a cardio-respiratory polysomnography (PSG), and a liver ultrasound. Results: All subjects had a clinical diagnosis of OSA based on the AHI > 1/h (mean AHI 8.0 ± 5.9; range 2.21–19.0). Of these, 69 showed hepatic steatosis (62.3% as mild, 20.3% as moderate, and 17.4% as severe degree). A strong association between ALT and apnea/hypopnea index (AHI) was observed (p = 0.0003). This association was not confirmed after adjusting for hepatic steatosis (p = 0.53). By subdividing our population according to the presence/absence of steatosis, this association was found only in the steatosis group (p = 0.009). As the severity of steatosis increased, the significance of its association with AHI compared to the absence of steatosis became progressively stronger (all p < 0.0001). Conclusions: Hepatic steatosis seems to drive the association between OSA and ALT levels, suggesting a potential pathogenic role of OSA in NAFLD.

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Section: Introductionmentioning

confidence: 99%

Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity

et al. 2021

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“…Lipotoxicity is projected to be one of the major triggers of liver injury in a multiple-hit model during the different stages of the MAFLD spectrum. Overconsumption of nutrients leads to increased visceral adipose tissue and increased mobilization rates of fatty acids to the liver, along with a decrease in adiponectin release and an increase in the release of pro-inflammatory cytokines 26 . The decrease of serum adiponectin may lead to accumulation of fat in the liver, liver inflammation and IR 34 .…”

Section: Pathophysiology Of Nafld/mafldmentioning

confidence: 99%

“…2,25 Lipotoxicity plays an essential role in the pathogenesis of MAFLD. 4,26 Increased insulin resistance (IR) in skeletal muscle/ adipose tissue and pathological alterations in the gut microbiota affect hepatic lipid metabolism, which further promotes hepatic inflammation and fat accumulation (Figure 1). 2…”

Section: Pathophysiology Of Nafld/mafldmentioning

confidence: 99%

“…Overconsumption of nutrients leads to increased visceral adipose tissue and increased mobilization rates of fatty acids to the liver, along with a decrease in adiponectin release and an increase in the release of pro-inflammatory cytokines. 26 The decrease of serum adiponectin may lead to accumulation of fat in the liver, liver inflammation and IR. 34 High levels of fatty acids cause over-stimulation of fatty acid oxidation and reactive oxygen species generation pathways, and increase the effects of oxidative stress on endoplasmic reticulum and mitochondrial physiology.…”

Section: Lipotoxicitymentioning

confidence: 99%

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Renaming NAFLD to MAFLD: Advantages and Potential Changes in Diagnosis, Pathophysiology, Treatment, and Management

Rui

Yang

et al. 2022

Infectious Microbes and Diseases

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In recent years, with the increasing incidence of obesity and other metabolic diseases, the prevalence of non-alcoholic fatty liver disease (NAFLD) has increased and it has become a major health problem affecting more than one quarter of the world's population. Recently, experts reached a consensus that NAFLD does not reflect the current knowledge, and metabolic dysfunction-associated fatty liver disease (MAFLD) was suggested as a more appropriate term. MAFLD is not just a simple renaming of NAFLD. The definition of MAFLD allows a patient to have dual (or more) etiologies for their liver disease, which will help to exclude more heterogeneous patients. In this review, we introduce the significant differences between the definitions of NAFLD and MAFLD. In addition, we also describe the advantages of the term MAFLD in the pathophysiology, therapy, and patient management.

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“…Recognizing this close association with metabolic risk factors identifies patients with a worse prognosis when compared with patients diagnosed using the past criteria for non-alcoholic fatty liver disease (NAFLD) [ 1 ]. Multiple consensus panels have accepted the definition and use of the term MAFLD [ 4 – 6 ]. New criteria for the diagnosis of MAFLD have resulted in the inclusion of a significant proportion of the population who are now recognized to be at increased cardiometabolic risk, resulting in improved diagnosis and management [ 4 – 6 ].…”

mentioning

confidence: 99%

Editorial: Treatment with Dual Incretin Receptor Agonists to Maintain Normal Glucose Levels May Also Maintain Normal Weight and Control Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)

et al. 2022

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Worldwide, metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common chronic liver disease. MAFLD is associated with insulin resistance, type 2 diabetes mellitus (T2DM), obesity, hypertension, and dyslipidemia. Early diagnosis and management are vital to improving hepatic and cardiometabolic outcomes. Dietary change, weight loss, and structured exercise are the main treatment approaches for fatty liver disease. Since 2010, several investigational drug treatments failed to achieve regulatory approval due to mixed and unsatisfactory results. Although glucagon-like peptide 1 receptor agonists (GLP1-RAs) showed initial promise as therapeutic agents, metabolic liver damage can recur after monotherapy cessation. Dual incretin receptor agonists target the receptors for glucagon-like peptide 1 (GLP-1) and gastric inhibitory peptide (GIP). Importantly, on May 13, 2022, the US Food and Drug Administration (FDA) approved tirzepatide as the first dual GLP-1 and GIP receptor agonist for the treatment of T2DM. Dual incretin receptor agonists induce weight loss and enhance hepatic lipid metabolism and systemic insulin sensitivity. Insulin resistance and hepatic steatosis are the main contributors to the development of MAFLD. Treatment with dual incretin analogs reduces hepatic steatosis, lobular inflammation, liver cell damage, fibrosis, and total liver triglyceride levels. The availability of dual incretin receptor agonists for patients with MAFLD may result in weight control, normalizing insulin sensitivity, and reducing or even reversing metabolic dysfunction and liver damage. This Editorial aims to provide an update and discuss how treatment with dual incretin receptor agonists may maintain normal glucose levels and weight and control MAFLD.

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A Review of the Increasing Prevalence of Metabolic-Associated Fatty Liver Disease (MAFLD) in Children and Adolescents Worldwide and in Mexico and the Implications for Public Health

Cited by 16 publications

References 68 publications

Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity

Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity

Renaming NAFLD to MAFLD: Advantages and Potential Changes in Diagnosis, Pathophysiology, Treatment, and Management

Editorial: Treatment with Dual Incretin Receptor Agonists to Maintain Normal Glucose Levels May Also Maintain Normal Weight and Control Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)

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