https://pubmed.ncbi.nlm.nih.gov/37592398/ NAFLD

J Pediatr Gastroenterol Nutr. 2023 Aug 18.
doi: 10.1097/MPG.0000000000003919.Online ahead of print.

Updates in metabolic dysfunction-associated fatty liver disease (MAFLD) in children

Kushila Rupasinghe 1, Jonathan Hind 2, Robert Hegarty 3

Abstract
The obesity epidemic is one of the major health concerns of the 21 st century. Non-alcoholic fatty liver disease (NAFLD) is linked with the increased adiposity associated with obesity. NAFLD has become the most frequent cause of chronic liver disease in adults and children worldwide. Metabolic dysfunction-associated fatty liver disease (MAFLD) also known in children as paediatric fatty liver disease type 2 has begun to supersede NAFLD as the preferred nomenclature in the paediatric population. Evidence suggests the aetiology of MAFLD is multifactorial, related to the complex interplay of hormonal, nutritional, genetic, and environmental factors. Current limitations in accurate diagnostic biomarkers have rendered it a diagnosis of exclusion and it is important to exclude alternative or co-existing causes of paediatric fatty liver disease. Lifestyle changes and modifications remains the primary treatment modality in MAFLD in children. Weight loss of 7-10% is described as reversing MAFLD in most patients. The Mediterranean diet also shows promise in reversing MAFLD. Pharmacological intervention is debatable in children, and though paediatric trials haven't shown promise, other agents undergoing adult clinical trials show promise. This review outlines the latest evidence in paediatric MAFLD and its management.