Pediatric nonalcoholic fatty liver disease.
Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease related to excessive accumulation of hepatic fat, and represents a spectrum of liver disease ranging from fat accumulation alone (steatosis) to the more significant histologic finding of steatohepatitis. Nonalcoholic steatohepatitis is a progressive liver disease associated with increased risk of liver cirrhosis and cancer. NAFLD is becoming increasingly prevalent in the pediatric population in direct correlation with the emergence of childhood obesity as a significant pediatric health problem. The exact pathophysiology of NAFLD remains unclear, although the interplay of insulin resistance, oxidative stress, and release of proinflammatory cytokines are implicated in the process. The diagnostic workup and treatment for NAFLD and nonalcoholic steatohepatitis remains controversial. This review discusses current concepts regarding the natural history, pathophysiology, and management of pediatric patients with NAFLD.
Lerret
Stacee M
SM
Division of Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA. slerret@mcw.edu
Skelton
Joseph A
JA
D017668:Age of Onset; D000465:Algorithms; D050110:Bariatric Surgery; D001706:Biopsy; D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications* / Q000517:prevention & control; D003663:Decision Trees; D003937:Diagnosis, Differential; D018450:Disease Progression; D042241:Early Diagnosis; D005234:Fatty Liver / Q000175:diagnosis / Q000196:embryology / Q000209:etiology / Q000628:therapy; D006801:Humans; D008019:Life Style; D008103:Liver Cirrhosis / Q000209:etiology; D008113:Liver Neoplasms / Q000209:etiology; D016031:Liver Transplantation; D009765:Obesity / Q000150:complications* / Q000517:prevention & control; D010371:Pediatric Nursing / Q000458:organization & administration; D015995:Prevalence; D012307:Risk Factors; D014810:Vitamin E / Q000627:therapeutic use
D014810:Vitamin E