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Review
. 2016 Jun 15;17(6):947.
doi: 10.3390/ijms17060947.

A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence

Jonathan L Temple  1 , Paul Cordero  2 , Jiawei Li  3 , Vi Nguyen  4 , Jude A Oben  5   6
Affiliations
Review

A Guide to Non-Alcoholic Fatty Liver Disease in Childhood and Adolescence

Jonathan L Temple et al. Int J Mol Sci. .

Abstract

Non-Alcoholic Fatty Liver Disease (NAFLD) is now the most prevalent form of chronic liver disease, affecting 10%-20% of the general paediatric population. Within the next 10 years it is expected to become the leading cause of liver pathology, liver failure and indication for liver transplantation in childhood and adolescence in the Western world. While our understanding of the pathophysiological mechanisms underlying this disease remains limited, it is thought to be the hepatic manifestation of more widespread metabolic dysfunction and is strongly associated with a number of metabolic risk factors, including insulin resistance, dyslipidaemia, cardiovascular disease and, most significantly, obesity. Despite this, "paediatric" NAFLD remains under-studied, under-recognised and, potentially, undermanaged. This article will explore and evaluate our current understanding of NAFLD in childhood and adolescence and how it differs from adult NAFLD, in terms of its epidemiology, pathophysiology, natural history, diagnosis and clinical management. Given the current absence of definitive radiological and histopathological diagnostic tests, maintenance of a high clinical suspicion by all members of the multidisciplinary team in primary and specialist care settings remains the most potent of diagnostic tools, enabling early diagnosis and appropriate therapeutic intervention.

Keywords: NAFLD; adolescent; children; obesity; steatosis.

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Figures

Figure 1
Figure 1
Obesity and Non-Alcoholic Fatty Liver Disease (NAFLD). Abbreviations: NAFLD: non-alcoholic fatty liver disease; NASH: non-alcoholic steatohepatitis.
Figure 2
Figure 2
Diagnostic tools for children and adolescent NAFLD. Abbreviations: NAFLD: non-alcoholic fatty liver disease; DM: diabetes mellitus; ALT: alanine aminotransferase; AST: aspartate aminotransferase; TG: triglycerides; FFA: free fatty acids; Chol: cholesterol.
Figure 3
Figure 3
Management of paediatric NAFLD.
See this image and copyright information in PMC

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