Lin Yu-Cheng, Liao Fang-Min, Chao Hsun-Ching, Chen An-Chyi, Jeng Yung-Ming, Lin Chieh-Chung, Tiao Mao-Meng, Yang Yao-Jong, Yeung Chun-Yan, Chen Huey-Ling, Ni Yen-Hsuan
Department of Pediatrics Taipei Veterans General Hospital Taipei Taiwan.
Department of Healthcare Administration Asia Eastern University of Science and Technology New Taipei City Taiwan.
JGH Open. 2025 Jun 12;9(6):e70137. doi: 10.1002/jgh3.70137. eCollection 2025 Jun.
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver condition in children and adolescents, driven by the global rise in pediatric obesity. In this consensus statement by the Taiwan Association for the Study of the Liver (TASL) and the Taiwan Society of Pediatric Gastroenterology, Hepatology, and Nutrition (TSPGHAN), we highlight the unique clinical challenges in diagnosing and managing this condition in Asian children.
This consensus was developed by expert members of TASL and TSPGHAN through a comprehensive review of current literature and clinical practice. Key topics included prevalence, screening policies, diagnostic criteria, disease characteristics, and management strategies relevant to pediatric MASLD.
We emphasize the rising prevalence of pediatric MASLD, which correlates strongly with obesity but often remains underdiagnosed due to the lack of screening policy for at-risk individuals and variations in diagnostic criteria. This review also discusses the distinct natural history and histopathological features of pediatric MASLD, underscoring the critical need for a greater understanding of its long-term outcomes. Currently, liver enzymes and ultrasonography are commonly used for screening and diagnosis, though these methods have limitations. The diagnostic imaging and novel non-invasive biomarkers specifically tailored for pediatric MASLD are in urgent need. Clinical management continues to rely on lifestyle interventions, with no pharmacological treatments currently approved for pediatric MASLD.
Effective management of pediatric MASLD requires a comprehensive approach to risk assessment, early detection, and intervention, tailored to the disease's unique pathophysiology in children.
代谢功能障碍相关脂肪性肝病（MASLD）是儿童和青少年中最常见的慢性肝病，由全球儿童肥胖率上升所致。在台湾肝脏研究协会（TASL）和台湾小儿胃肠病学、肝病学与营养学会（TSPGHAN）的这份共识声明中，我们强调了在亚洲儿童中诊断和管理这种疾病所面临的独特临床挑战。
本共识由TASL和TSPGHAN的专家成员通过全面回顾当前文献和临床实践制定而成。关键主题包括与儿童MASLD相关的患病率、筛查政策、诊断标准、疾病特征及管理策略。
我们强调儿童MASLD患病率不断上升，其与肥胖密切相关，但由于缺乏针对高危个体的筛查政策以及诊断标准的差异，该疾病常未得到充分诊断。本综述还讨论了儿童MASLD独特的自然史和组织病理学特征，强调迫切需要更深入了解其长期预后。目前，肝酶和超声检查常用于筛查和诊断，不过这些方法存在局限性。迫切需要专门针对儿童MASLD的诊断成像和新型非侵入性生物标志物。临床管理仍依赖生活方式干预，目前尚无获批用于儿童MASLD的药物治疗。
有效管理儿童MASLD需要采取综合方法进行风险评估、早期检测和干预，根据该疾病在儿童中的独特病理生理学特点进行量身定制。
