Pathogenesis of non-alcoholic fatty liver disease in children and adolescence: From “two hit theory” to “multiple hit model”

Nonalcoholic fatty liver disease (NAFLD) has become the dominant form of chronic liver disease in children and adolescents with the increasing prevalence of obesity worldwide. NAFLD represents a wide spectrum of conditions, ranging from fatty liver - which generally follows a benign, non-progressive...

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Published inWorld journal of gastroenterology : WJG Vol. 24; no. 27; pp. 2974 - 2983
Main Authors Fang, Yan-Lan, Chen, Hong, Wang, Chun-Lin, Liang, Li
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 21.07.2018
Subjects
Review
Nonalcoholic fatty liver disease
Children
Adolescents
Non-alcoholic steatohepatitis
Pathogenesis
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Summary:Nonalcoholic fatty liver disease (NAFLD) has become the dominant form of chronic liver disease in children and adolescents with the increasing prevalence of obesity worldwide. NAFLD represents a wide spectrum of conditions, ranging from fatty liver - which generally follows a benign, non-progressive clinical course - to non-alcoholic steatohepatitis, a subset of NAFLD that may progress to cirrhosis and end-stage liver disease or liver carcinoma. The underlying pathophysiological mechanism of "pediatric" NAFLD remains unclear, although it is strongly associated with obesity and insulin resistance. In this review we provide a general overview on the current understanding of NAFLD in children and adolescents, which underpins practice, enabling early diagnosis and appropriate therapeutic intervention for this life-threatening liver disease.
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Author contributions: Fang YL primarily analyzed the data and wrote the paper; Chen H collected data and contributed to the writing of the manuscript; Wang CL provided essential analytical tools; Liang L supervised the design and contributed to the writing of the manuscript.
Correspondence to: Li Liang, MD, Chief Doctor, Professor, Department of Pediatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. zdliangli@zju.edu.cn
Supported by The National Key Research and Development Program of China, No. 2016YFC1305301.
ISSN:1007-9327
2219-2840
2219-2840
DOI:10.3748/wjg.v24.i27.2974