Perspectives on youth-onset nonalcoholic fatty liver disease.
Perspectives on youth-onset nonalcoholic fatty liver disease.
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DOI：
10.1002/edm2.184
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发表时间：
2020-10
影响因子：
--
通讯作者：
Vos MB
中科院分区：
文献类型：
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作者：
Castillo-Leon E;Cioffi CE;Vos MB
青少年发病的非酒精性脂肪肝（NAFLD）的患病率和发病率远远超过其他儿童慢性肝病，是全球一个相当大的公共卫生问题。在这里，我们对儿科 NAFLD 流行病学的当前知识、发病机制、合并症、诊断和管理以及与成年过渡相关的问题的选定概念进行了叙述性回顾。儿童 NAFLD 已变得越来越普遍，尤其是在某些亚组中，例如肥胖儿童和某些种族/民族。儿科 NAFLD 的病理生理学是复杂且多因素的，由环境和遗传因素的相互作用驱动。一旦发生，儿童时期的 NAFLD 与 2 型糖尿病、高血压、心血管疾病风险增加和终末期肝病相关。这预示着青少年和年轻人的发病率和死亡率负担将会增加。因此，早期筛查和诊断至关重要，无创生物标志物的开发仍然是一个活跃的研究领域。目前，治疗策略主要集中在生活方式的改变上，但也有对药物和手术选择的研究兴趣。在从儿科护理过渡到成人护理的过程中，治疗存在一些潜在的挑战/障碍，需要进行研究以了解在此期间如何最好地支持患者。近几十年来，我们对儿科 NAFLD 的流行病学和病理生理学的了解已大大增加，但仍然存在一些关键的知识差距，必须加以解决，以便更好地减轻青少年发病的 NAFLD 的短期和长期风险。青年发病的非酒精性脂肪肝病（NAFLD）的患病率和发病率远远超过其他慢性肝病。在儿童中，NAFLD 与 2 型糖尿病、高血压、心血管疾病风险增加和终末期肝病相关。这预示着青少年和年轻人的发病率和死亡率负担将会增加。
The prevalence and incidence of youth‐onset nonalcoholic fatty liver disease (NAFLD) far exceeds other paediatric chronic liver diseases and represents a considerable public health issue globally. Here, we performed a narrative review of current knowledge regarding the epidemiology of paediatric NAFLD, selected concepts in pathogenesis, comorbidities, diagnosis, and management, and issues related to the transition to adulthood. Paediatric NAFLD has become increasingly more prevalent, especially in certain subgroups, such as children with obesity and certain races/ethnicities. The pathophysiology of paediatric NAFLD is complex and multifactorial, driven by an interaction of environmental and genetic factors. Once developed, NAFLD in childhood is associated with type 2 diabetes, hypertension, increased cardiovascular disease risk, and end‐stage liver disease. This predicts an increased burden of morbidity and mortality in adolescents and young adults. Early screening and diagnosis are therefore crucial, and the development of noninvasive biomarkers remains an active area of investigation. Currently, treatment strategies are focused on lifestyle changes, but there is also research interest in pharmacological and surgical options. In the transition from paediatric to adult care, there are several potential challenges/barriers to treatment and research is needed to understand how best to support patients during this time. Our understanding of the epidemiology and pathophysiology of paediatric NAFLD has increased considerably over recent decades, but several critical knowledge gaps remain and must be addressed in order to better mitigate the short‐term and long‐term risks of youth‐onset NAFLD. The prevalence and incidence of youth‐onset nonalcoholic fatty liver disease (NAFLD) far surpasses other chronic liver diseases. In children, NAFLD is associated with type 2 diabetes, hypertension, increased cardiovascular disease risk, and end‐stage liver disease. This predicts an increased burden of morbidity and mortality in adolescents and young adults.