Advances in pediatric nonalcoholic fatty liver disease.
Advances in pediatric nonalcoholic fatty liver disease.
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DOI：
10.1002/hep.23119
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发表时间：
2009-10
期刊：
影响因子：
13.5
通讯作者：
Lavine, Joel E.
中科院分区：
文献类型：
--
作者：
Loomba, Rohit;Sirlin, Claude B.;Schwimmer, Jeffrey B.;Lavine, Joel E.
非酒精性脂肪性肝病(NAFLD)已成为美国儿童和青少年慢性肝病的主要原因。在过去的20年里，儿童肥胖率和超重率上升了两到三倍，这可能是NAFLD流行的原因。新出现的数据表明，患有NASH的儿童会进展为肝硬变，最终可能会增加与肝脏相关的死亡率。更令人担忧的是，人们认识到儿童和青少年的心血管风险和发病率与脂肪肝有关。儿童脂肪性肝病通常表现出与成人不同的组织学模式。肝活检仍是诊断NASH的金标准。需要非侵入性生物标记物来识别进行性肝损伤的个体。需要针对性的治疗来改善与脂肪肝相关的肝脏组织学和代谢异常。目前，随机对照试验正在儿科人群中进行，以确定NAFLD的药物治疗。需要公众的健康意识和干预，以促进健康的饮食、锻炼和生活方式的改变，以预防和减轻社区的疾病负担。
Nonalcoholic fatty liver disease (NAFLD) has emerged as the leading cause of chronic liver disease in children and adolescents in the United States. A two- to three-fold rise in the rates of obesity and overweight in children over the last 2 decades is probably responsible for the epidemic of NAFLD. Emerging data suggest that children with NASH progress to cirrhosis which may ultimately increase liver-related mortality. More worrisome is the recognition that cardiovascular risk and morbidity in children and adolescents is associated with fatty liver. Pediatric fatty liver disease often displays a histologic pattern distinct from that found in adults. Liver biopsy remains the gold standard for diagnosis of NASH. Non-invasive biomarkers are needed to identify individuals with progressive liver injury. Targeted therapies to improve liver histology and metabolic abnormalities associated with fatty liver are needed. Currently, randomized-controlled trials are underway in the pediatric population to define pharmacologic therapy for NAFLD. Public health awareness and intervention are needed to promote healthy diet, exercise, and lifestyle modifications to prevent and reduce the burden of disease in the community.
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