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Pediatric nonalcoholic fatty liver disease: a critical appraisal of current data and implications for future research.
J Pediatr Gastroenterol Nutr 2006; 43(4):413-27JP

Abstract

Although population prevalence is very difficult to establish, nonalcoholic fatty liver disease (NAFLD) is probably the most common cause of liver disease in the preadolescent and adolescent age groups. There seems to be an increase in the prevalence of NAFLD, likely related to the dramatic rise in the incidence of obesity during the past 3 decades. Despite an increase in public awareness, overweight/obesity and related conditions, such as NAFLD, remain underdiagnosed by health care providers. Accurate diagnosis and staging of nonalcoholic steatohepatitis (NASH) requires liver biopsy. The development of noninvasive surrogate markers and the advancements in imaging technology will aid in the screening of large populations at risk for NAFLD. Two distinct histological patterns of NASH have been identified in the pediatric population, and discrete clinical and demographic features are observed in children with these 2 patterns. The propensity for NASH to develop in obese, insulin-resistant pubertal boys of Hispanic ethnicity or a non-Hispanic white race may provide clues to the pathogenesis of NAFLD in children. The natural history of pediatric NASH has yet to be defined, but most biopsies in this age group demonstrate some degree of fibrosis. In addition, cirrhosis can be observed in children as young as 10 years. While the optimal treatment of pediatric NAFLD has yet to be determined, lifestyle modification through diet and exercise should be attempted in children diagnosed with NAFLD. A large, multicenter trial of vitamin E and metformin is underway as part of the NASH clinical research network.

Authors+Show Affiliations

Division of Gastroenterology, Department of Medicine, University of California, San Diego, CA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

17033514

Citation

Patton, Heather M., et al. "Pediatric Nonalcoholic Fatty Liver Disease: a Critical Appraisal of Current Data and Implications for Future Research." Journal of Pediatric Gastroenterology and Nutrition, vol. 43, no. 4, 2006, pp. 413-27.
Patton HM, Sirlin C, Behling C, et al. Pediatric nonalcoholic fatty liver disease: a critical appraisal of current data and implications for future research. J Pediatr Gastroenterol Nutr. 2006;43(4):413-27.
Patton, H. M., Sirlin, C., Behling, C., Middleton, M., Schwimmer, J. B., & Lavine, J. E. (2006). Pediatric nonalcoholic fatty liver disease: a critical appraisal of current data and implications for future research. Journal of Pediatric Gastroenterology and Nutrition, 43(4), pp. 413-27.
Patton HM, et al. Pediatric Nonalcoholic Fatty Liver Disease: a Critical Appraisal of Current Data and Implications for Future Research. J Pediatr Gastroenterol Nutr. 2006;43(4):413-27. PubMed PMID: 17033514.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pediatric nonalcoholic fatty liver disease: a critical appraisal of current data and implications for future research. AU - Patton,Heather M, AU - Sirlin,Claude, AU - Behling,Cynthia, AU - Middleton,Michael, AU - Schwimmer,Jeffrey B, AU - Lavine,Joel E, PY - 2006/10/13/pubmed PY - 2006/10/25/medline PY - 2006/10/13/entrez SP - 413 EP - 27 JF - Journal of pediatric gastroenterology and nutrition JO - J. Pediatr. Gastroenterol. Nutr. VL - 43 IS - 4 N2 - Although population prevalence is very difficult to establish, nonalcoholic fatty liver disease (NAFLD) is probably the most common cause of liver disease in the preadolescent and adolescent age groups. There seems to be an increase in the prevalence of NAFLD, likely related to the dramatic rise in the incidence of obesity during the past 3 decades. Despite an increase in public awareness, overweight/obesity and related conditions, such as NAFLD, remain underdiagnosed by health care providers. Accurate diagnosis and staging of nonalcoholic steatohepatitis (NASH) requires liver biopsy. The development of noninvasive surrogate markers and the advancements in imaging technology will aid in the screening of large populations at risk for NAFLD. Two distinct histological patterns of NASH have been identified in the pediatric population, and discrete clinical and demographic features are observed in children with these 2 patterns. The propensity for NASH to develop in obese, insulin-resistant pubertal boys of Hispanic ethnicity or a non-Hispanic white race may provide clues to the pathogenesis of NAFLD in children. The natural history of pediatric NASH has yet to be defined, but most biopsies in this age group demonstrate some degree of fibrosis. In addition, cirrhosis can be observed in children as young as 10 years. While the optimal treatment of pediatric NAFLD has yet to be determined, lifestyle modification through diet and exercise should be attempted in children diagnosed with NAFLD. A large, multicenter trial of vitamin E and metformin is underway as part of the NASH clinical research network. SN - 1536-4801 UR - https://www.unboundmedicine.com/medline/citation/17033514/Pediatric_nonalcoholic_fatty_liver_disease:_a_critical_appraisal_of_current_data_and_implications_for_future_research_ L2 - http://Insights.ovid.com/pubmed?pmid=17033514 DB - PRIME DP - Unbound Medicine ER -