title: Similarities and differences between pediatric and adult nonalcoholic fatty liver disease.
abstract: Nonalcoholic fatty liver disease (NAFLD) is highly common and potentially serious in children and adolescents. The term NAFLD refers to a spectrum of diseases ranging from accumulation of fat in the liver (simple steatosis or nonalcoholic fatty liver "NAFL") to the potentially progressive form of nonalcoholic steatohepatitis (NASH) characterized by hepatocyte ballooning, inflammation, and often associated with fibrosis. While large prospective longitudinal studies in pediatric NAFLD are still lacking, growing evidence suggests that children with NAFL are at increased risk for cardiometabolic complications, while those with NASH and advance fibrosis are also at risk for significant liver-related morbidity including cirrhosis and its complications. Pediatric NAFLD shares features of adult NAFLD but also shows many different characteristics in terms of prevalence, histology, diagnosis and management. Translational studies suggest that NAFLD is a highly heritable disease in which genetic variations and environment closely interact to determine the disease phenotype and the progression to the more advanced forms of the disease. Changes in lifestyle, targeting gradual weight reduction, and physical exercise continue to be the mainstay of treatment for NAFLD in children. Recent advances in development of noninvasive diagnostic modalities and the potential for identifying effective pharmacological interventions may result in significant progress in the management of NAFLD in the pediatric population.
authors.affiliation: Department of Pediatric Gastroenterology, Rainbow Babies and Children's Hospital, Cleveland, OH, USA.
authors.forename: Maricruz
authors.initials: M
authors.lastname: Crespo
authors.affiliation: Department of Pediatrics, Cleveland Clinic Children's, Cleveland, OH, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Lappe
authors.affiliation: Department of Pediatric Gastroenterology, University of California San Diego (UCSD), CA, USA.
authors.forename: Ariel E
authors.initials: AE
authors.lastname: Feldstein
authors.affiliation: Department of Pediatric Gastroenterology, Cleveland Clinic Children's, Cleveland, OH, USA; Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: alkhoun@ccf.org.
authors.forename: Naim
authors.initials: N
authors.lastname: Alkhouri
mesh_terms: D000328:Adult; D000367:Age Factors; D002648:Child; D018450:Disease Progression; D005234:Fatty Liver / Q000175:diagnosis* / Q000473:pathology; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008019:Life Style; D008099:Liver / Q000473:pathology*; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
keywords: Children; Liver fibrosis; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Noninvasive diagnosis