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Obese children with fatty liver: Between reality and disease mongering.
World J Gastroenterol 2017; 23(47):8277-8282WJ

Abstract

Following the current epidemic of obesity, the worldwide prevalence of nonalcoholic fatty liver disease (NAFLD) has increased with potential serious health implications. While it is established that in adults NAFLD can progress to end-stage liver disease in many cases, the risk of progression during childhood is less well defined. Since most obese children are not adherent to lifestyle modifications and hypocaloric diets, there is a growing number of studies on pharmacological interventions with the risk of disease mongering, the practice of widening the boundaries of illness in order to expand the markets for treatment. Here, we propose a critical appraisal of the best available evidence about long-term course of pediatric NAFLD and efficacy of treatments other than hypocaloric diet and physical exercise. As a result, the number of NAFLD children with a poor outcome is small in spite of the alarming tones used in some papers; large-scale longitudinal studies with long-term follow-up of pediatric NAFLD patients are lacking; the studies on ancillary pharmacological interventions have been performed in few patients with inconclusive and conflicting results.

Authors+Show Affiliations

Department of Translational Medical Science, Section of Pediatrics, University Federico II, Naples 80131, Italy.Department of Translational Medical Science, Section of Pediatrics, University Federico II, Naples 80131, Italy.Department of Translational Medical Science, Section of Pediatrics, University Federico II, Naples 80131, Italy. riorio@unina.it.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29307987

Citation

Ranucci, Giusy, et al. "Obese Children With Fatty Liver: Between Reality and Disease Mongering." World Journal of Gastroenterology, vol. 23, no. 47, 2017, pp. 8277-8282.
Ranucci G, Spagnuolo MI, Iorio R. Obese children with fatty liver: Between reality and disease mongering. World J Gastroenterol. 2017;23(47):8277-8282.
Ranucci, G., Spagnuolo, M. I., & Iorio, R. (2017). Obese children with fatty liver: Between reality and disease mongering. World Journal of Gastroenterology, 23(47), pp. 8277-8282. doi:10.3748/wjg.v23.i47.8277.
Ranucci G, Spagnuolo MI, Iorio R. Obese Children With Fatty Liver: Between Reality and Disease Mongering. World J Gastroenterol. 2017 Dec 21;23(47):8277-8282. PubMed PMID: 29307987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obese children with fatty liver: Between reality and disease mongering. AU - Ranucci,Giusy, AU - Spagnuolo,Maria Immacolata, AU - Iorio,Raffaele, PY - 2017/10/23/received PY - 2017/11/14/revised PY - 2017/12/04/accepted PY - 2018/1/9/entrez PY - 2018/1/9/pubmed PY - 2018/8/9/medline KW - Children KW - Cirrhosis KW - Disease mongering KW - Liver transplant KW - Non alcoholic fatty liver disease KW - Non alcoholic steatohepatitis KW - Obesity SP - 8277 EP - 8282 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 23 IS - 47 N2 - Following the current epidemic of obesity, the worldwide prevalence of nonalcoholic fatty liver disease (NAFLD) has increased with potential serious health implications. While it is established that in adults NAFLD can progress to end-stage liver disease in many cases, the risk of progression during childhood is less well defined. Since most obese children are not adherent to lifestyle modifications and hypocaloric diets, there is a growing number of studies on pharmacological interventions with the risk of disease mongering, the practice of widening the boundaries of illness in order to expand the markets for treatment. Here, we propose a critical appraisal of the best available evidence about long-term course of pediatric NAFLD and efficacy of treatments other than hypocaloric diet and physical exercise. As a result, the number of NAFLD children with a poor outcome is small in spite of the alarming tones used in some papers; large-scale longitudinal studies with long-term follow-up of pediatric NAFLD patients are lacking; the studies on ancillary pharmacological interventions have been performed in few patients with inconclusive and conflicting results. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/29307987/Obese_children_with_fatty_liver:_Between_reality_and_disease_mongering_ L2 - http://www.wjgnet.com/1007-9327/full/v23/i47/8277.htm DB - PRIME DP - Unbound Medicine ER -