Non-Alcoholic Fatty Liver Disease in the Pediatric Population
- Pp. 164-176 (13)Zsuzsanna Almássy
In the past decade, obesity has reached epidemic magnitude among children and adolescents, thus associated pathologic conditions are increasing simultaneously. These conditions include insulin resistance, type 2 diabetes, metabolic syndrome, cardiovascular diseases (CVD) and fatty liver disease (NAFLD).
NAFLD, previously thought to impact adults only, shares many of the same features of the metabolic syndrome, a highly atherogenic condition. This drew increased focus to study the role of NAFLD in relation to higher overall mortality and morbidity rates and increased prevalence of cardiovascular disease (CVD).
Insulin resistance is the pathophysiologic hallmark of NAFLD, the most common form of chronic liver disease in children in today’s time. It is characterized by triglyceride accumulation with secondary free-radical production, which induces inflammatory processes and fibrosis due to numerous causes and complex mechanism.
Recent studies indicate that NAFLD has high prevalence in obese children, which has serious cosequences without treatment. Early intervention is utmost important when NAFLD is diagnosed, which should include early lifestyle modification (nutrition and physical activity, avoidance of smoking), however, no evidence based therapeutic approaches exist.