Defining paediatric metabolic (dysfunction)-associated fatty liver disease: an international expert consensus statement
Defining paediatric metabolic (dysfunction)-associated fatty liver disease: an international expert consensus statement
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DOI：
10.1016/s2468-1253(21)00183-7
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发表时间：
2021-09-09
影响因子：
35.7
通讯作者：
George, Jacob
中科院分区：
文献类型：
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作者：
Eslam, Mohammed;Alkhouri, Naim;George, Jacob
术语非酒精性脂肪性肝病（NAFLD）及其定义对于成人和儿童都有局限性。这一定义对儿童来说问题最大，因为对他们来说，饮酒通常不是一个问题。这个有问题的定义促使人们达成共识，将与代谢失调相关的成人NAFLD重新命名和重新定义为代谢（功能障碍）相关的脂肪肝疾病（MAFLD）。与成人相比，儿童脂肪肝的病因、自然史和预后存在相似性、区别和差异。在本观点中，我们作为一个国际小组，提出了儿科脂肪肝疾病的总体框架，以及基于性别和年龄差异的适合年龄的MAFLD定义。该框架认识到儿童中其他共存的全身性脂肪肝疾病的可能性。新的MAFLD诊断标准为儿科医生提供了疾病诊断、风险分层以及改善临床和多学科护理的概念框架，并且与整个生命周期有效的定义保持一致。
The term non-alcoholic fatty liver disease (NAFLD), and its definition, have limitations for both adults and children. The definition is most problematic for children, for whom alcohol consumption is usually not a concern. This problematic definition has prompted a consensus to rename and redefine adult NAFLD associated with metabolic dysregulation to metabolic (dysfunction)-associated fatty liver disease (MAFLD). Similarities, distinctions, and differences exist in the causes, natural history, and prognosis of fatty liver diseases in children compared with adults. In this Viewpoint we, an international panel, propose an overarching framework for paediatric fatty liver diseases and an age-appropriate MAFLD definition based on sex and age percentiles. The framework recognises the possibility of other coexisting systemic fatty liver diseases in children. The new MAFLD diagnostic criteria provide paediatricians with a conceptual scaffold for disease diagnosis, risk stratification, and improved clinical and multidisciplinary care, and they align with a definition that is valid across the lifespan.