Pediatric Nonalcoholic Fatty Liver Disease Management
Summary
Paediatric nonalcoholic fatty liver disease (NAFLD) management has emerged as a global priority with prevalence estimates up to 10–20% in general child and adolescent populations and markedly higher rates among those with obesity. NAFLD is now regarded as the hepatic manifestation of systemic metabolic dysfunction, spanning a spectrum from simple steatosis through non-alcoholic steatohepatitis (NASH) to advanced fibrosis. Early recognition hinges on a combination of serum biomarkers—chiefly alanine aminotransferase (ALT)—and imaging techniques such as ultrasound and non-invasive elastography. Lifestyle modification remains the cornerstone of therapy, focusing on balanced nutrition, increased physical activity and behavioural support, while pharmacological agents and bariatric procedures are under investigation for cases refractory to first-line measures. Advances in non-invasive risk scores and novel biomarkers are refining patient stratification, enabling targeted surveillance for disease progression. A multidisciplinary approach involving paediatric hepatology, endocrinology, nutrition and psychology is essential to translate evolving evidence into personalised care pathways and to mitigate long-term hepatic and cardiometabolic complications on a global scale.
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Pediatric Nonalcoholic Fatty Liver Disease Management publication trend
The graph below shows the total number of articles in pediatric nonalcoholic fatty liver disease management across all publications each year (not limited to Nature Index journals).
Technical terms
Nonalcoholic fatty liver disease (NAFLD): spectrum of hepatic fat accumulation in the absence of significant alcohol intake.
Metabolic-associated fatty liver disease (MAFLD): NAFLD defined by hepatic steatosis combined with evidence of metabolic dysfunction.
Steatosis: excess triglyceride deposition within hepatocytes.
Fibrosis: progressive accumulation of extracellular matrix proteins in the liver.
Alanine aminotransferase (ALT): enzyme released into the bloodstream in response to hepatocellular injury.
References
- Risk factors and cardio-metabolic outcomes associated with metabolic-associated fatty liver disease in childhood. EClinicalMedicine (2023).
- A natural history study of paediatric non-alcoholic fatty liver disease over 10 years. JHEP Reports (2023).
- The Prevalence of Non-Alcoholic Fatty Liver Disease in Children and Adolescents: A Systematic Review and Meta-Analysis. PLOS ONE (2015).
- Comparison of diagnostic accuracy of screening tests ALT and ultrasound for pediatric non-alcoholic fatty liver disease. European Journal of Pediatrics (2019).
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