Nonalcoholic fatty liver disease in children.
OBJECTIVE
The intent of this review is to provide a concise overview of all recent acquisitions in terms of therapies and early noninvasive diagnostic approaches for nonalcoholic fatty liver disease (NAFLD) in children.


RESULTS
NAFLD is increasingly being diagnosed in children. If undiscovered and if certain risks are present (i.e. obesity), nonalcoholic steatohepatitis, the most severe form of NAFLD, may silently progress to cirrhosis, hepatocarcinoma and liver-related death in adulthood. Current therapies include approaches for reducing the incidence of risk factors (i.e. weight reduction), drugs targeting the major molecular mechanisms thought essential in the pathogenesis of the disease (insulin resistance and oxidative stress) or both, but other novel treatments are under investigation.


CONCLUSIONS
Although weight reduction, achieved through a combination of diet and exercise, makes it possible to modify the natural course of simple steatosis, the addition of adequate drugs might also provide a therapeutic action on nonalcoholic steatohepatitis. Moreover, preventive strategies and the design and translation into clinical practice of indices that integrate noninvasive diagnostic tools and serum biomarkers might be a winning approach for improving management of paediatric NAFLD/nonalcoholic steatohepatitis in the coming years.
Unit of Metabolic and Autoimmune Liver Diseases, Pediatric Hospital IRCCS Bambino Gesù, Rome, Italy.
Anna
A
Alisi
Mattia
M
Locatelli
Valerio
V
Nobili
D002648:Child; D005234:Fatty Liver / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D007333:Insulin Resistance; D009765:Obesity / Q000150:complications*; D018384:Oxidative Stress; D015995:Prevalence; D012307:Risk Factors