Caring for children with NAFLD and navigating their care into adulthood.
NAFLD is the most common chronic liver disease in children and adults, with its prevalence closely associated with obesity and other features of the metabolic syndrome. As young adults with NAFLD transition from the paediatric care environment to adult services, establishing a coordinated model of transition to ensure ongoing and appropriate care is critical. Enabling a smooth transfer begins with an understanding of the key differences between paediatric and adult NAFLD as well as the psychosocial factors that affect older adolescents. This Review summarizes the literature on paediatric NAFLD from the past two decades with a focus on the differences in epidemiology, pathology, pathophysiology and treatment that are relevant to clinicians who transition paediatric patients to adult care. An integrated model, which employs a team of adult and paediatric providers who can address the psychosocial, cognitive and logistical challenges of transition, provides the best opportunity for a seamless and coordinated transfer to adult care.
Division of Paediatric Gastroenterology, Hepatology and Nutrition, Columbia University Medical Centre, 622 West 168th Street, New York, NY 10032, USA.
Ali A
AA
Mencin
Division of Gastroenterology, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
Rohit
R
Loomba
Division of Paediatric Gastroenterology, Hepatology and Nutrition, Columbia University Medical Centre, 622 West 168th Street, New York, NY 10032, USA.
Joel E
JE
Lavine
D000293:Adolescent; D000465:Algorithms; D002648:Child; D004032:Diet; D006801:Humans; D008019:Life Style; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000628:therapy*; D060305:Transition to Adult Care; D055815:Young Adult