Review article: epidemiology, pathogenesis and potential treatments of paediatric non-alcoholic fatty liver disease
Article first published online: 4 APR 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 28, Issue 1, pages 13–24, July 2008
How to Cite
BARSHOP, N. J., SIRLIN, C. B., SCHWIMMER, J. B. and LAVINE, J. E. (2008), Review article: epidemiology, pathogenesis and potential treatments of paediatric non-alcoholic fatty liver disease. Alimentary Pharmacology & Therapeutics, 28: 13–24. doi: 10.1111/j.1365-2036.2008.03703.x
- Issue published online: 2 JUN 2008
- Article first published online: 4 APR 2008
- Publication data Submitted 27 March 2008 First decision 31 March 2008 Resubmitted 31 March 2008 Accepted 1 April 2008 Epub OnlineAccepted 4 April 2008
Background Non-alcoholic fatty liver disease (NAFLD) is the most common cause of paediatric liver disease. Similar to NAFLD in adults, NAFLD in children is associated with obesity and insulin resistance and requires liver histology for diagnosis and staging. However, significant histological differences exist between adult and paediatric NAFLD to warrant caution in extrapolation of adult data.
Aim To review the available data on the epidemiology, pathogenesis, diagnosis and treatment of paediatric NAFLD.
Methods Relevant articles were identified by Medline searches using the keywords: nonalcoholic fatty liver disease, steatohepatitis, obesity and children.
Results The rise in childhood obesity has been accompanied by an increase in paediatric NAFLD. Age, gender and race/ethnicity are significant determinants of risk, and sex hormones, insulin sensitivity and adipocytokines are implicated in the pathogenesis of paediatric NAFLD. There is no consensus for treatment of NAFLD; however, data suggest that diet, exercise and some pharmacological therapies may be of benefit.
Conclusions To evaluate and effectively treat paediatric NAFLD, the pathophysiology and natural history of the disease should be clarified and non-invasive methods for screening, diagnosis, and longitudinal assessment developed. Randomized, controlled, double-blind trials of pharmacological therapies in children with biopsy-proven disease are necessary.