Metabolic dysfunction associated steatotic liver disease in children: current status and future prospects
Abstract
The issue of the correctness of using the term “non-alcoholic fatty liver disease” in relation to children with obesity and overweight has been repeatedly discussed by specialists. The recently proposed formulation “metabolic-associated fatty liver disease” more accurately reflects the nature of the pathological condition and eliminates the limitations of the previous definition. In recent years, the prevalence of metabolically associated fatty liver disease (MAFLD) has increased significantly along with the global increase in obesity, becoming the main cause of chronic liver diseases in children and adults. The updated terminology allows us to consider MAFLD as an independent condition along with other liver diseases that occur with manifestations of fatty degeneration. The latter include genetic and hereditary metabolic disorders that manifest in childhood and require careful diagnosis, for example, in cases where weight loss measures do not improve the patient’s condition or there is no obesity. The development of MAFLD appears to be the result of a complex interaction of nutritional, genetic, hormonal and environmental factors. Despite progress in diagnostics, existing noninvasive biomarkers have limited sensitivity and specificity for MAFLD, which necessitates imaging and histological studies for diagnosis. With lifestyle modification, nutritional behavior, and diet remaining the leading role in the prevention and treatment of MAFLD, therapeutic approaches continue to evolve. The article provides an overview of recent developments and promising treatments for MAFLD in children.
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