Advances in the Epidemiology, Diagnosis, and Management of Pediatric Fatty Liver Disease

Suri, Anandini; Song, Eric; Nispen, Johan van; Voigt, Mark M.; Armstrong, Austin; Murali, Vidul; Jain, Ajay K.

doi:10.1016/j.clinthera.2021.01.006

Cited by 9 publications

(11 citation statements)

References 99 publications

(16 reference statements)

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“…With the increasing incidence of metabolic abnormalities and diabetes amongst children and adolescents, the incidence of MAFLD in this age bracket has also increased. [ 26 ] Interestingly, the prevalence of MAFLD in pediatric populations differs between regions with the highest prevalence in Asia. [ 27 ] In Asia, the prevalence of pediatric MAFLD has been increasing, particularly in obese male population over the age of 10.…”

Section: Mafld In Childrenmentioning

confidence: 99%

“…[ 28 ] In the US, as reported in the “Study of Child and Adolescent Liver Epidemiology (SCALE)”, MAFLD is present in 5% to 10% of children/adolescents aged 2 to 19 years. [ 26 ] A meta-analysis by Anderson et al [ 27 ] found that MAFLD prevalence in the general pediatric population ranged from 9% to 37%. Similar to the findings in adults, the prevalence of MAFLD in children and adolescents is higher in males than in females and incrementally increases with BMI.…”

Section: Mafld In Childrenmentioning

confidence: 99%

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From MAFLD to hepatocellular carcinoma and everything in between

Bae

George

Qiao

2022

Chinese Medical Journal

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Metabolic (dysfunction) associated fatty liver disease (MAFLD), previously known as non-alcoholic fatty liver disease, is the most common cause of chronic liver disease worldwide. Many risk factors contribute to the pathogenesis of MAFLD with metabolic dysregulation being the final arbiter of its development and progression. MAFLD poses a substantial economic burden to societies, which based on current trends is expected to increase over time. Numerous studies have addressed various aspects of MAFLD from its risk associations to its economic and social burden and clinical diagnosis and management, as well as the molecular mechanisms linking MAFLD to end-stage liver disease and hepatocellular carcinoma. This review summarizes current understanding of the pathogenesis of MAFLD and related diseases, particularly liver cancer. Potential therapeutic agents for MAFLD and diagnostic biomarkers are discussed.

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Section: Mafld In Childrenmentioning

confidence: 99%

Section: Mafld In Childrenmentioning

confidence: 99%

From MAFLD to hepatocellular carcinoma and everything in between

Bae

George

Qiao

2022

Chinese Medical Journal

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“…Obese subjects were divided into two groups as NAFLD and non-NAFLD. NAFLD assessment is more effective in obese children using US together with alanine aminotransferase (ALT) (14,15). NAFLD was defined according to the ultrasound findings (hepatorenal echo contrast, liver brightness, deep attenuation, and vascular wall turbidity together with) and elevated serum ALT levels (≥30 IU/L) (16)(17)(18).…”

Section: Study Populationmentioning

confidence: 99%

Non-Alkolik Yağlı Karaciğer Hastalığı Olan ve Olmayan Obez Çocuklarda Hepatik Vasküler Akım Değişikliklerinin Değerlendirilmesi

Aydın

Aydınoğlu

Atar

et al. 2021

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Objective: To evaluate hepatic vascular flow alterations using Doppler ultrasound in obese children with and without nonalcoholic fatty liver disease. Material and Methods: Ninety-one obese and 30 healthy lean (control) children were enrolled in this study. Obese children were divided into two groups: children with non-alcoholic fatty liver disease and children without non-alcoholic fatty liver disease; according to hepatic fatty changes on ultrasound, and blood serum alanine aminotransferase levels above 30 IU/L. Portal vein diameter, portal blood flow volume and hepatic artery resistive index were calculated using Doppler ultrasound. Results: Portal vein diameter and portal blood flow volume values in children with non-alcoholic fatty liver disease were found close to the controls. However, the values of portal vein diameter and portal blood flow volume were lower in children without non-alcoholic fatty liver disease group than the other groups (p<0.001). Hepatic artery resistive index was higher in children without non-alcoholic fatty liver disease group than children with non-alcoholic fatty liver disease group (0.64±0.1 and 0.60±0.1, respectively) (p=0.03), whereas hepatic artery resistive index was found to be close in children with nonalcoholic fatty liver disease and controls. These findings were similar to the differences in hepatic vascular changes observed during the development of non-alcoholic fatty liver disease, which were described in physio-pathological studies. Conclusion: Portal vein diameter, portal blood flow volume and hepatic artery resistive index values in obese children show significant differences according to the presence or absence of fatty liver. These differences are consistent with hepatic physio-pathological changes in non-alcoholic fatty liver disease. Therefore, hepatic vascular Doppler indices may be a new tool that can be used to monitor the development and progression of non-alcoholic fatty liver disease in obese children.

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“…Pediatric non-alcoholic fatty liver disease (NAFLD) is a major public health problem that has raised concern worldwide. In recent years, NAFLD has developed into one of the most common chronic diseases affecting children as young as two years of age, and the prevalence is continuing to increase [1][2][3]. The rate of pediatric patients with NAFLD has more than doubled in recent decades and has persisted across gender and racial/ethnic subgroups [4].…”

Section: Introductionmentioning

confidence: 99%

“…Participant has either steatohepatitis on Brunt assessment or NAS Score ≥ 4 2. Fibrosis is determined by fibrosis stage ≥ 1 on either Brunt or NAS 3. Advanced fibrosis is determined by fibrosis stage ≥ 3 on either Brunt or NAS.…”

mentioning

confidence: 99%

Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease

Castillo‐Leon¹,

Morris²,

Schoen³

et al. 2022

Children

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Background: Pediatric non-alcoholic fatty liver disease (NAFLD) is a major public health concern. Aminotransferase (ALT) is frequently used for screening and monitoring, but few studies have reported typical patterns of ALT elevation in children. Methods: TARGET-NASH is a real-world longitudinal observational cohort of patients with NAFLD receiving care across the United States. Analyses included children enrolled between 1 August 2016, and 12 October 2020, with at least one ALT measurement after enrollment. Peak ALT was based on the first and last available record and categorized into clinical cut points: <70 IU/L, >70–<250 IU/L, and >250 IU/L. A chi-squared test was used to compare differences in proportions, and a Kruskal–Wallis test was used to compare the medians and distributions of continuous responses. Results: Analyses included 660 children with a median age of 13 years. Of the 660, a total of 187 had undergone a biopsy and were more likely to be Hispanic or Latino (67% vs. 57%, p = 0.02) and to have cirrhosis (10% vs. 1%, p < 0.001). The highest ALT scores ranged from 28 U/L to 929 U/L; however, these scores varied across time. The prevalence of cirrhosis or any liver fibrosis stage was most common among children with a peak ALT > 70 U/L. Conclusions: Large variability was seen in ALT among children, including many values > 250 U/L. Higher levels of ALT were associated with increased prevalence of comorbidities and more advanced stages of NAFLD. These findings support an increased need for therapeutics and disease severity assessment in children with peak ALT > 70 U/L.

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Advances in the Epidemiology, Diagnosis, and Management of Pediatric Fatty Liver Disease

Cited by 9 publications

References 99 publications

From MAFLD to hepatocellular carcinoma and everything in between

From MAFLD to hepatocellular carcinoma and everything in between

Non-Alkolik Yağlı Karaciğer Hastalığı Olan ve Olmayan Obez Çocuklarda Hepatik Vasküler Akım Değişikliklerinin Değerlendirilmesi

Variation in Alanine Aminotransferase in Children with Non-Alcoholic Fatty Liver Disease

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