Division of Paediatric Gastroenterology, Hepatology and Nutrition, Columbia University Medical Centre, 622 West 168th Street, New York, NY 10032, USA.
Division of Gastroenterology, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
Nat Rev Gastroenterol Hepatol. 2015 Nov;12(11):617-28. doi: 10.1038/nrgastro.2015.146. Epub 2015 Sep 1.
NAFLD is the most common chronic liver disease in children and adults, with its prevalence closely associated with obesity and other features of the metabolic syndrome. As young adults with NAFLD transition from the paediatric care environment to adult services, establishing a coordinated model of transition to ensure ongoing and appropriate care is critical. Enabling a smooth transfer begins with an understanding of the key differences between paediatric and adult NAFLD as well as the psychosocial factors that affect older adolescents. This Review summarizes the literature on paediatric NAFLD from the past two decades with a focus on the differences in epidemiology, pathology, pathophysiology and treatment that are relevant to clinicians who transition paediatric patients to adult care. An integrated model, which employs a team of adult and paediatric providers who can address the psychosocial, cognitive and logistical challenges of transition, provides the best opportunity for a seamless and coordinated transfer to adult care.
非酒精性脂肪性肝病（NAFLD）是儿童和成人中最常见的慢性肝病，其患病率与肥胖症和代谢综合征的其他特征密切相关。患有 NAFLD 的年轻人从儿科医疗环境过渡到成人医疗服务，建立协调的过渡模式以确保持续和适当的治疗至关重要。实现平稳过渡的关键是了解儿科和成人 NAFLD 的主要区别，以及影响大龄青少年的心理社会因素。这篇综述总结了过去 20 年来关于儿科 NAFLD 的文献，重点介绍了与将儿科患者过渡到成人护理的临床医生相关的流行病学、病理学、病理生理学和治疗方面的差异。采用由成人和儿科提供者组成的综合团队模式，可以解决过渡的心理社会、认知和后勤挑战，为无缝和协调的过渡到成人护理提供了最佳机会。
