Non-Alcoholic Fatty Liver Disease in Children

Abstract

Background and Objectives: The prevalence of pediatric non-alcoholic fatty liver disease is increasing. A lot of new data are published regularly. Materials and Methods: Original clinical studies, review articles, and guidelines in children were searched for and the most relevant included in this review. Results: A total of 138 retrieved papers were classified into pathogenesis, epidemiology, diagnosis, and treatment. Pathogenesis is currently explained with the “multi hit hypothesis”, with complex interactions of genetic and environmental factors which trigger inflammation in steatotic liver. The prevalence is rising. A diagnosis can be made with laboratory tests, imaging, and liver biopsy after the exclusion of other causes of liver steatosis. The mainstay of treatment is lifestyle modification consisting of dietary intervention and increased physical activity. The progression to liver cirrhosis can occur even in children. Conclusions: Non-alcoholic fatty liver disease in children is a part of a metabolic syndrome in the majority of patients. Due to its complex etiology and high prevalence, multidisciplinary teams, together with public health professionals, should be involved in its treatment.

Childhood Obesity: Position Statement of Polish Society of Pediatrics, Polish Society for Pediatric Obesity, Polish Society of Pediatric Endocrinology and Diabetes, the College of Family Physicians in Poland and Polish Association for Study on Obesity

“…In the treatment of MAFLD, a diet with limited simple carbohydrates and increased fiber consumption is strongly recommended [79,80]. The introduction of supplements with ω−3 polyunsaturated fatty acids was postulated to reduce liver steatosis [80], but was not confirmed in other studies [81].…”

Liver Biopsy Handling of Metabolic-Associated Fatty Liver Disease (MAFLD): the Children’s Hospital of Eastern Ontario grossing protocol

“…Standard procedures for liver biopsy handling and processing have been established in several organizations, and guidelines have been collected. 19 – 24 We will divide the handling and processing into three sections, pre-analytical, analytical, and post-analytical. The pre-analytical handling entails taking the biopsy and transferring the material to the department of laboratory medicine and pathology.…”

Puerarin Induces Macrophage M2 Polarization to Exert Antinonalcoholic Steatohepatitis Pharmacological Activity via the Activation of Autophagy

“…1 In developed countries, there has been a concerning trend of NAFLD affecting younger children, with approximately 3−10% of children and 34% of obese children being diagnosed with NAFLD. 2 NAFLD is a generic term encompassing nonalcoholic fatty liver (NAFL), non-alcoholic steatohepatitis (NASH), and NASH-related cirrhosis. 3 NAFL is characterized by the presence of simple steatosis without hepatocellular damage, while NASH is distinguished by the histological evidence of hepatocyte damage and inflammation with or without fibrosis.…”

“…Non-alcoholic fatty liver disease (NAFLD) is a prevalent chronic liver disease worldwide, with an estimated current global prevalence of approximately 30% . In developed countries, there has been a concerning trend of NAFLD affecting younger children, with approximately 3–10% of children and 34% of obese children being diagnosed with NAFLD . NAFLD is a generic term encompassing non-alcoholic fatty liver (NAFL), non-alcoholic steatohepatitis (NASH), and NASH-related cirrhosis .…”