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Current Pediatric Reviews

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ISSN (Print): 1573-3963
ISSN (Online): 1875-6336

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General Review Article

Metabolic Associated Fatty Liver Disease in Children and Adolescents: Mechanisms of a Silent Epidemic and Therapeutic Options

Author(s): Antonella Mosca*, Luca Della Volpe, Maria Rita Sartorelli, Donatella Comparcola, Silvio Veraldi, Anna Alisi and Giuseppe Maggiore

Volume 20, Issue 3, 2024

Published on: 12 May, 2023

Page: [296 - 304] Pages: 9

DOI: 10.2174/1573396319666230403121805

Price: $65

Abstract

Non-alcoholic fatty liver disease (NAFLD) is now identified as a hepatic sign of metabolic syndrome and is the most frequent cause of chronic liver disease in all ages. It is assumed that a genetic predisposition associated with epigenetic factors participates in the evolution of this condition. Visceral obesity and insulin resistance (IR) have always been considered the most important causative factors of Metabolic Syndrome (MetS) and NAFLD, but currently, the interaction between genetic heritage and environmental factors is increasingly considered fundamental in the genesis of metabolic disorders associated with NAFLD. In fact, in patients with NAFLD, insulin resistance, arterial hypertension, abdominal obesity, dyslipidemia and reduced intestinal permeability have often been found, as well as a higher prevalence of coronary artery disease, obstructive sleep apnea, polycystic ovary syndrome and osteopenia, which define a MetS framework. Early diagnosis is needed to prevent disease progression through primarily lifestyle interventions. Unfortunately, at present, there are no molecules recommended for pediatric patients. However, several new drugs are in clinical trials. For this reason, targeted studies on the interaction between genetics and environmental factors involved in the development of NAFLD and MetS and on the pathogenetic mechanisms that determine the evolution in non-alcoholic steatohepatitis (NASH), should be implemented. Therefore, it is desirable that future studies may be useful in identifying patients at risk of developing NAFLD and MetS early.

Keywords: Metabolic Syndrome, NAFL, NASH, uric acid, probiotics, DHA, vitamin D.

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Graphical Abstract

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