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Advances in pediatric nonalcoholic fatty liver disease
Author(s) -
Loomba Rohit,
Sirlin Claude B.,
Schwimmer Jeffrey B.,
Lavine Joel E.
Publication year - 2009
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.23119
Subject(s) - medicine , nonalcoholic fatty liver disease , cirrhosis , liver biopsy , fatty liver , overweight , chronic liver disease , liver disease , population , steatohepatitis , disease , metabolic syndrome , obesity , gastroenterology , biopsy , environmental health
Nonalcoholic fatty liver disease (NAFLD) has emerged as the leading cause of chronic liver disease in children and adolescents in the United States. A two‐ to three‐fold rise in the rates of obesity and overweight in children over the last two decades is probably responsible for the NAFLD epidemic. Emerging data suggest that children with nonalcoholic steatohepatitis (NASH) progress to cirrhosis, which may ultimately increase liver‐related mortality. More worrisome is the recognition that cardiovascular risk and morbidity in children and adolescents are associated with fatty liver. Pediatric fatty liver disease often displays a histologic pattern distinct from that found in adults. Liver biopsy remains the gold standard for diagnosis of NASH. Noninvasive biomarkers are needed to identify individuals with progressive liver injury. Targeted therapies to improve liver histology and metabolic abnormalities associated with fatty liver are needed. Currently, randomized‐controlled trials are underway in the pediatric population to define pharmacologic therapy for NAFLD. Conclusion: Public health awareness and intervention are needed to promote healthy diet, exercise, and lifestyle modifications to prevent and reduce the burden of disease in the community. (H EPATOLOGY 2009.)