Mitsinikos Tania, Aw Marion M, Bandsma Robert, Godoy Marcela, Ibrahim Samar H, Mann Jake P, Memon Iqbal, Mohan Neelam, Mouane Nezha, Porta Gilda, Verduci Elvira, Xanthakos Stavra
Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital Los Angeles, Los Angeles, California, USA.
Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
J Pediatr Gastroenterol Nutr. 2025 Mar;80(3):397-407. doi: 10.1002/jpn3.12399. Epub 2024 Dec 27.
As rates of obesity rise worldwide, incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly referred to as nonalcoholic fatty liver disease, is increasing, worsening the burden of healthcare systems. The council of the Federation of International Societies for Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN) identified the topic of MASLD epidemiology, treatment, and prevention as a global priority issue to be addressed by an expert team, with the goal to describe feasible and evidence-based actions that may contribute to reducing MASLD risk. The FISPGHAN member societies nominated experts in the field. The FISPGHAN council selected and appointed members of the expert team and a chair. The subtopics included in this manuscript were chosen through a consensus of the experts involved. We review the epidemiology, natural history, and screening and management. We further expand to relevant public health measures aimed at MASLD prevention, including identifying interventions that could reduce risk factors (environmental and iatrogenic), optimize maternal and newborn health, and support healthier lifestyles for older children and adolescents on a local, national, and international scale. While recognizing that various aspects of population health and public policy can shape MASLD risk, we also review what we can do on an individual level to support our patients to reduce the significant burden of this ever rising disease in pediatrics.
随着全球肥胖率上升，代谢功能障碍相关脂肪性肝病（MASLD，原称非酒精性脂肪性肝病）的发病率不断增加，加重了医疗系统的负担。国际儿科胃肠病学、肝病学和营养学会联合会（FISPGHAN）理事会将MASLD的流行病学、治疗和预防主题确定为一个全球优先问题，由一个专家团队来解决，目标是描述可能有助于降低MASLD风险的可行且基于证据的行动。FISPGHAN成员协会提名了该领域的专家。FISPGHAN理事会挑选并任命了专家团队成员和一位主席。本手稿中包含的子主题是通过相关专家的共识选定的。我们回顾了流行病学、自然史以及筛查和管理。我们还进一步扩展到旨在预防MASLD的相关公共卫生措施，包括确定可以降低风险因素（环境和医源性）的干预措施、优化母婴健康，以及在地方、国家和国际层面支持大龄儿童和青少年更健康的生活方式。在认识到人群健康和公共政策的各个方面会影响MASLD风险的同时，我们也探讨在个人层面我们可以做些什么来帮助我们的患者减轻这种儿科领域中不断增加的疾病所带来的重大负担。
