Pediatr Gastroenterol Hepatol Nutr.  2019 Nov;22(6):501-510. 10.5223/pghn.2019.22.6.501.

New Perspectives in Pediatric Nonalcoholic Fatty Liver Disease: Epidemiology, Genetics, Diagnosis, and Natural History

• Ko JS

• KMID: 2462089
• DOI: http://doi.org/10.5223/pghn.2019.22.6.501

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children. The global prevalence of pediatric NAFLD from general populations is 7.6%. In obese children, the prevalence is higher in Asia. NAFLD has a strong heritable component based on ethnic difference in the prevalence and clustering within families. Genetic polymorphisms of patatin-like phospholipase domain-containing protein 3 (PNPLA3), transmembrane 6 superfamily member 2, and glucokinase regulatory protein (GCKR) are associated with the risk of NAFLD in children. Variants of PNPLA3 and GCKR are more common in Asians. Alterations of the gut microbiome might contribute to the pathogenesis of NAFLD. High fructose intake increases the risk of NAFLD. Liver fibrosis is a poor prognostic factor for disease progression to cirrhosis. Magnetic resonance spectroscopy and magnetic resonance proton density fat fraction are more accurate for steatosis quantification than ultrasound. Noninvasive imaging methods to assess liver fibrosis, such as transient elastography, shear-wave elastography, and magnetic resonance elastography are useful in predicting advanced fibrosis, but they need further validation. Longitudinal follow-up studies into adulthood are needed to better understand the natural history of pediatric NAFLD.

Keyword

Nonalcoholic fatty liver disease; Children; Epidemiology; Genetics; Microbiome; Liver fibrosis; Asia

MeSH Terms

Asia
Asian Continental Ancestry Group
Child
Diagnosis*
Disease Progression
Elasticity Imaging Techniques
Epidemiology
Fibrosis
Follow-Up Studies
Fructose
Gastrointestinal Microbiome
Genetics
Glucokinase
Humans
Liver Cirrhosis
Liver Diseases
Magnetic Resonance Spectroscopy
Microbiota
Natural History*
Non-alcoholic Fatty Liver Disease*
Phospholipases
Polymorphism, Genetic
Prevalence
Protons
Ultrasonography
Fructose
Glucokinase
Phospholipases
Protons

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