Pediatric NAFLD: an overview and recent developments in diagnostics and treatment

Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in children and adults in industrialized countries. Besides liver-related morbidity, NAFLD is also associated with an increased risk of cardiovascular disease, type 2 diabetes and mortality at adult age. However, despite the high prevalence and serious complications, diagnosing and staging of disease remains complicated due to a lack of accurate screening tools and non-invasive methods to detect fibrosis. Areas covered: Recent insights in epidemiology, pathogenesis, diagnostic evaluation and treatment options in pediatric NAFLD are being reviewed, with a particular focus on new developments in diagnostic tools. Expert opinion: Due to their long life span, children with NAFLD are particularly at risk of complications in their lifetime. Therefore, an effective screening strategy for children to identify those with NAFLD at risk of complications is urgently needed. This is further underscored by new pharmacological therapies that are expected to become available in the next 5 years. Momentarily no accurate non-invasive method for diagnosing pediatric NAFLD is available. New promising biomarkers and imaging tools could hopefully provide better screening tools and could contribute to the development of a successful management plan to identify children with NAFLD.

引言：非酒精性脂肪性肝病（NAFLD）是工业化国家儿童和成人中最常见的慢性肝病。除肝脏相关疾病发病率外，NAFLD还与心血管疾病、2型糖尿病和成年期死亡率增加的风险相关。然而，尽管发病率高且并发症严重，但由于缺乏准确的筛查工具和非侵入性检测纤维化的方法，疾病的诊断和分期仍然复杂。涵盖内容：本文回顾了儿童NAFLD在流行病学、发病机制、诊断评估和治疗选择方面的最新进展，特别关注诊断工具的新发展。专家观点：由于寿命较长，NAFLD儿童在其一生中特别容易发生并发症。因此，迫切需要一种有效的筛查策略，以识别NAFLD的高风险儿童。这一观点得到了未来5年内有望上市的新药理疗法的进一步强化。目前，尚无准确的非侵入性方法用于诊断儿童NAFLD。新的有希望的生物标志物和成像工具有望提供更好的筛查工具，并有助于成功管理计划的制定，以识别患有NAFLD的儿童。