https://pubmed.ncbi.nlm.nih.gov/38677287/ NAFLD

Med. 2024 Apr 24:S2666-6340(24)00129-6.
doi: 10.1016/j.medj.2024.03.017.Online ahead of print.

An international multidisciplinary consensus on pediatric metabolic dysfunction-associated fatty liver disease

Le Zhang 1, Mortada El-Shabrawi 2, Louise A Baur 3, Christopher D Byrne 4, Giovanni Targher 5, Mohit Kehar 6, Gilda Porta 7, Way Seah Lee 8, Sander Lefere 9, Serap Turan 10, Anna Alisi 11, Ram Weiss 12, Maria Felicia Faienza 13, Ambika Ashraf 14, Shikha S Sundaram 15, Anshu Srivastava 16, Ruth De Bruyne 17, Yunkoo Kang 18, Flora Bacopoulou 19, Yong-Hai Zhou 20, Andy Darma 21, Monica Lupsor-Platon 22, Masahide Hamaguchi 23, Anoop Misra 24, Nahum Méndez-Sánchez 25, Nicholas Beng Hui Ng 26, Claude Marcus 27, Amanda E Staiano 28, Nadia Waheed 29, Saleh A Alqahtani 30, Cosimo Giannini 31, Ponsiano Ocama 32, Mindie H Nguyen 33, Maria Teresa Arias-Loste 34, Mohamed Rabea Ahmed 35, Giada Sebastiani 36, Yong Poovorawan 37, Mamun Al Mahtab 38, Juan M Pericàs 39, Themis Reverbel da Silveira 40, Peter Hegyi 41, Amer Azaz 42, Hasan M Isa 43, Chatmanee Lertudomphonwanit 44, Mona Issa Farrag 2, Ahmed Abd Alwahab Nugud 2, Hong-Wei Du 45, Ke-Min Qi 46, Nezha Mouane 47, Xin-Ran Cheng 48, Tawfiq Al Lawati 49, Eleonora D T Fagundes 50, Hasmik Ghazinyan 51, Adamos Hadjipanayis 52, Jian-Gao Fan 53, Nicoleta Gimiga 54, Naglaa M Kamal 55, Gabriela Ștefănescu 56, Li Hong 57, Smaranda Diaconescu 58, Ming Li 59, Jacob George 60, Ming-Hua Zheng 61
Affiliations expand
PMID: 38677287

DOI: 10.1016/j.medj.2024.03.017
Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in children and adolescents, particularly those with obesity. NAFLD is considered a hepatic manifestation of the metabolic syndrome due to its close associations with abdominal obesity, insulin resistance, and atherogenic dyslipidemia. Experts have proposed an alternative terminology, metabolic dysfunction-associated fatty liver disease (MAFLD), to better reflect its pathophysiology. This study aimed to develop consensus statements and recommendations for pediatric MAFLD through collaboration among international experts.

Methods: A group of 65 experts from 35 countries and six continents, including pediatricians, hepatologists, and endocrinologists, participated in a consensus development process. The process encompassed various aspects of pediatric MAFLD, including epidemiology, mechanisms, screening, and management.

Findings: In round 1, we received 65 surveys from 35 countries and analyzed these results, which informed us that 73.3% of respondents agreed with 20 draft statements while 23.8% agreed somewhat. The mean percentage of agreement or somewhat agreement increased to 80.85% and 15.75%, respectively, in round 2. The final statements covered a wide range of topics related to epidemiology, pathophysiology, and strategies for screening and managing pediatric MAFLD.

Conclusions: The consensus statements and recommendations developed by an international expert panel serve to optimize clinical outcomes and improve the quality of life for children and adolescents with MAFLD. These findings emphasize the need for standardized approaches in diagnosing and treating pediatric MAFLD.