Background:The prevalence and incidence of youth-onset nonalcoholic fatty liver disease (NAFLD) far exceeds other paediatric chronic liver diseases and represents a considerable public health issue globally.Methods:Here, we performed a narrative review of current knowledge regarding the epidemiology of paediatric NAFLD, selected concepts in pathogenesis, comorbidities, diagnosis, and management, and issues related to the transition to adulthood.Results:Paediatric NAFLD has become increasingly more prevalent, especially in certain subgroups, such as children with obesity and certain races/ethnicities. The pathophysiology of paediatric NAFLD is complex and multifactorial, driven by an interaction of environmental and genetic factors. Once developed, NAFLD in childhood is associated with type 2 diabetes, hypertension, increased cardiovascular disease risk, and end-stage liver disease. This predicts an increased burden of morbidity and mortality in adolescents and young adults. Early screening and diagnosis are therefore crucial, and the development of noninvasive biomarkers remains an active area of investigation. Currently, treatment strategies are focused on lifestyle changes, but there is also research interest in pharmacological and surgical options. In the transition from paediatric to adult care, there are several potential challenges/barriers to treatment and research is needed to understand how best to support patients during this time.Conclusions:Our understanding of the epidemiology and pathophysiology of paediatric NAFLD has increased considerably over recent decades, but several critical knowledge gaps remain and must be addressed in order to better mitigate the short-term and long-term risks of youth-onset NAFLD.? 2020 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
展开▼
机译：背景：青少年非酒精性脂肪肝病（NAFLD）的患病率和发病率远远超过其他儿科慢性肝病，并代表了全球相当大的公共卫生问题。方法：在这里，我们对儿科的流行病学进行了对目前知识的叙述审查NAFLD，在发病机制，合并症，诊断和管理方面的选定概念以及与转型到Afulthood的问题。结果：儿科NAFLD变得越来越普遍，特别是在某些亚组中，例如肥胖的儿童和某些种族/种族。儿科NAFLD的病理生理学是复杂的和多因素，由环境和遗传因素的相互作用驱动。一旦发达，儿童时期的NAFLD与2型糖尿病，高血压，增加心血管疾病风险以及终末期肝病有关。这预测了青少年和年轻成年人的发病率和死亡率增加。因此，早期筛查和诊断至关重要，非侵入性生物标志物的发展仍然是一个活跃的调查领域。目前，治疗策略专注于生活方式的变化，但还对药理学和手术选择的研究兴趣。在从儿科到成人护理的过渡中，需要几种潜在的挑战/治疗障碍，需要研究，了解在此期间如何最好地支持患者。结论：我们对儿科NAFLD的流行病学和病理生理学的理解近期增加了大众化数十年，但仍然有几个关键知识差距，必须解决，以便更好地减轻青年发病NAFLD的短期和长期风险。 2020作者。 John Wiley＆Sons Ltd.出版的内分泌，糖尿病和新陈代谢
展开▼
