Review article: the management of paediatric nonalcoholic fatty liver disease

@article{Mitchel2014ReviewAT,
  title={Review article: the management of paediatric nonalcoholic fatty liver disease},
  author={Elana B. Mitchel and Joel E. Lavine},
  journal={Alimentary Pharmacology \& Therapeutics},
  year={2014},
  volume={40}
}
Paediatric nonalcoholic fatty liver disease (NAFLD) is a major public health concern given the recent increase in its prevalence and link to obesity and other metabolic comorbidities. Current treatment strategies involve lifestyle changes. Other surgical and pharmacologic interventions have been proposed; however, limited randomised controlled trials (RCTs) in the paediatric population restrict their use. 
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An effective screening strategy for children to identify those with NAFLD at risk of complications is urgently needed, and new promising biomarkers and imaging tools could hopefully provide better screening tools and contribute to the development of a successful management plan.
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References

SHOWING 1-10 OF 204 REFERENCES
Nonalcoholic fatty liver disease and bariatric surgery in adolescents.
TLDR
A highlight of the current understanding ofNAFLD pathogenesis and disease characteristics is provided, with updates on the challenges of NAFLD management in obese and severely obese patients and recommendations for the pediatric surgeons' role in the care of SO adolescents.
Review article: epidemiology, pathogenesis and potential treatments of paediatric non‐alcoholic fatty liver disease
TLDR
Significant histological differences exist between adult and paediatric NAFLD to warrant caution in extrapolation of adult data.
Advances in pediatric nonalcoholic fatty liver disease.
A critical appraisal of advances in pediatric nonalcoholic Fatty liver disease.
TLDR
An overview of current concepts in epidemiology, histologic features, diagnosis, pathophysiology, genetic risk factors, and treatment of NAFLD in children is provided.
Diagnosis and treatment of pediatric nonalcoholic steatohepatitis and the implications for bariatric surgery.
TLDR
heightened physician awareness of NAFLD, NASH, and associated risk factors is important to identify and treat affected children and clinical trials focusing on NASH are needed.
Diagnosis of Nonalcoholic Fatty Liver Disease in Children and Adolescents: Position Paper of the ESPGHAN Hepatology Committee
TLDR
Indications for liver biopsy include the following: to rule out other treatable diseases, in cases of clinically suspected advanced liver disease, before pharmacological/surgical treatment, and as part of a structured intervention protocol or clinical research trial.
Histological progression of non‐alcoholic fatty liver disease: a critical reassessment based on liver sampling variability
In non‐alcoholic fatty liver disease, histological lesions display a significant sampling variability that is ignored when interpreting histological progression during natural history or therapeutic
A phase 2 clinical trial of metformin as a treatment for non‐diabetic paediatric non‐alcoholic steatohepatitis
TLDR
Children with non‐alcoholic steatohepatitis are insulin‐resistant and metformin has been proposed as a potential therapy, but paediatric safety and efficacy data are absent.
...
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3
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