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Paediatric non-alcoholic fatty liver disease: a practical overview for non-specialists
  1. Jake P Mann1,
  2. Rajiv Goonetilleke2,
  3. Pat McKiernan3
  1. 1Department of paediatrics, University of Cambridge, Cambridge, UK
  2. 2Children's unit, Hinchingbrooke Hospital, Huntingdon, UK
  3. 3Liver unit, Birmingham Children's Hospital, Birmingham, UK
  1. Correspondence to Dr Jake P Mann, Department of Paediatrics, University of Cambridge, Box 116, Level 8, Addenbrooke's Hospital, Hills Rd, Cambridge CB2 0QQ, UK; jakemann{at}doctors.org.uk

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common paediatric liver disease with a prevalence of almost 10%; therefore, the majority of affected patients are under the care of general practitioners and non-specialists. The condition is caused by central obesity with insulin resistance with additional factors influencing inflammatory activity (steatohepatitis). Ongoing inflammation leads to fibrosis and end-stage liver disease, though this will usually occur after children have transitioned into adult care. However, their main morbidity and mortality is from type 2 diabetes and complications of atherosclerosis. The minority of children undergo biopsy but currently there is no other method to accurately assess the stage of disease. Management is focused at weight loss through a combination of diet and exercise. Here, we present a current review of paediatric NAFLD aimed at non-specialists, with practice points for implementation.

  • Hepatology
  • Obesity
  • Metabolic
  • Endocrinology
  • Diabetes

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