Nonalcoholic fatty liver disease in the pediatric population.
Nonalcoholic fatty liver disease in the pediatric population.
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DOI：
10.1016/j.cld.2004.04.010
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发表时间：
2004-08-01
影响因子：
5.1
通讯作者：
Schwimmer, Jeffrey B
中科院分区：
文献类型：
--
作者：
Lavine, Joel E;Schwimmer, Jeffrey B
非酒精性脂肪性肝病（NAFLD）涵盖了肝脏中发现的一系列特征，这些特征充满了大泡脂肪和不同程度的炎症、细胞损伤和纤维化。根据定义，NAFLD不包括那些大量摄入酒精或脂肪性肝炎的替代潜在原因的人。NAFLD在肥胖儿童中发生，但罕见。鉴于全球儿童肥胖患病率的迅速上升，NAFLD现在被认为是儿科肝病的最常见原因。在肥胖个体中，西班牙裔和男性似乎会增加风险。最近的研究表明，胰岛素抵抗和氧化应激在发病机制中起重要作用。治疗试验正在进行中，以确定是否减少胰岛素抵抗或氧化应激将有利地影响结果。本文综述了儿童非酒精性脂肪性肝炎的患病率，人口统计学，临床表现，组织学，发病机制和治疗方面的知识。儿童和成人脂肪肝疾病之间的重要差异突出。
Nonalcoholic fatty liver disease (NAFLD) covers the spectrum of features found in liver laden with macrovesicular fat and variable degrees of inflammation, cell injury, and fibrosis. By definition, NAFLD excludes those with significant ingestion of alcohol or alternative potential cause of steatohepatitis. NAFLD develops with rare exception in children who are obese. Given the rapid rise in prevalence of obesity in children globally, NAFLD is now recognized as the most common cause of liver disease in pediatrics. In obese individuals, Hispanic ethnicity and male gender appear to increase risk. Recent studies suggest that insulin resistance and oxidative stress are important in pathogenesis. Treatment trials are underway to determine if reduction of insulin resistance or oxidative stress will favorably affect outcome. This review summarizes what is known about pediatric nonalcoholic steatohepatitis in terms of prevalence, demographics, clinical presentation, histology,pathogenesis, and treatment. Important differences between pediatric and adult fatty liver disease are highlighted.