Nonalcoholic fatty liver disease in children

Ahmed Dahshan, Laura J Chalmers, Vasundhara Tolia

Nonalcoholic fatty liver disease (NAFLD) is probably the most common form of chronic liver disease in children in the USA and may continue to rise with the increasing prevalence of childhood obesity and metabolic syndrome. Although the exact pathophysiology of NAFLD is not well understood, insulin resistance, oxidative stress and the release of proinfl ammatory cytokines are suggested factors in the cascade of reactions resulting in NAFLD. The best diagnostic workup and treatment for NAFLD and nonalcoholic steatohepatitis are still being debated; however, early intervention to halt further progression and/or to reverse the disease process is recommended. Further studies are needed to better understand the demographics, pathogenesis, treatment, natural history and long-term prognosis of pediatric NAFLD. This review discusses current concepts regarding these issues in pediatric patients with NAFLD.