Non-alcoholic fatty liver disease in childhood : review

Non-alcoholic fatty liver disease (NAFLD) is an often undiagnosed entity of chronic liver disease with an uncertain prognosis. Recently NAFLD has probably become the most frequent cause of chronic liver disease in children. The term NAFLD covers a spectrum of non-alcoholic fatty liver disease from benign static disease to more aggressive forms that can progress to cirrhosis within childhood. The term non-alcoholic steatohepatitis (NASH) is nowadays reserved to describe these progressive forms of NAFLD. Insulin resistance is a significant aetiological factor and hence a majority of patients with diabetes, obesity and the metabolic syndrome have the disease. Histological confirmation of NAFLD requires 5% steatosis to support the diagnosis and distinguishes an adult (NASH type 1) and a paediatric form (NASH type 2). Current treatment options focus on lifestyle changes to improve underlying obesity and glucose intolerance. This article provides an overview of currently existing data regarding diagnosis and management of children with suspected NAFLD.