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儿童非酒精性脂肪性肝病。

Nonalcoholic Fatty Liver Disease in Children.

机构信息

Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom.

Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Policlinico Milano, Università degli Studi di Milano, Milan, Italy.

出版信息

Semin Liver Dis. 2018 Feb;38(1):1-13. doi: 10.1055/s-0038-1627456. Epub 2018 Feb 22.

Abstract

Nonalcoholic steatohepatitis, a progressive form of nonalcoholic fatty liver disease (NAFLD), is one of the most common hepatic diseases in children who present with particular risk factors including obesity, sedentary lifestyle, and/or a predisposing genetic background. The worldwide prevalence of NAFLD in children is a worrying phenomenon because this disease is closely associated with the development of both cirrhosis and cardiometabolic syndrome in adulthood. To date, the etiopathogenesis of primary NAFLD in children is unknown. Understanding the pathogenetic mechanisms provides the basis to characterize early predictors of the disease and noninvasive diagnostic tools and to design novel specific treatments and possible management strategies. Despite a few clinical trials on the use of antioxidants combined with lifestyle intervention for NAFLD, no treatment exists for children with NAFLD. In this review, the authors provide an overview of current concepts in epidemiology, histological features, etiopathogenesis, diagnosis, and treatment of NAFLD in pediatric population.

摘要

非酒精性脂肪性肝炎(Nonalcoholic steatohepatitis,NASH)是一种进行性非酒精性脂肪性肝病(Nonalcoholic fatty liver disease,NAFLD),是肥胖、久坐不动的生活方式和/或易患遗传背景等特定危险因素的儿童中最常见的肝脏疾病之一。全球儿童 NAFLD 的患病率令人担忧,因为这种疾病与成年后肝硬化和代谢综合征的发展密切相关。迄今为止,儿童原发性 NAFLD 的病因发病机制尚不清楚。了解发病机制为疾病的早期预测因子和非侵入性诊断工具提供了基础,并为设计新的特异性治疗方法和可能的管理策略提供了基础。尽管有几项关于抗氧化剂联合生活方式干预治疗 NAFLD 的临床试验,但目前尚无治疗儿童 NAFLD 的方法。在这篇综述中,作者概述了儿科人群中 NAFLD 的流行病学、组织学特征、病因发病机制、诊断和治疗的最新概念。

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