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

World J Gastroenterol. 2018 Jul 21;24(27):2974-2983. doi: 10.3748/wjg.v24.i27.2974.

Abstract

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.

Keywords: Adolescents; Children; Non-alcoholic steatohepatitis; Nonalcoholic fatty liver disease; Pathogenesis.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Animals
  • Biomarkers / blood
  • Child
  • Dietary Carbohydrates / adverse effects
  • Humans
  • Insulin Resistance*
  • Lipid Metabolism
  • Liver / diagnostic imaging
  • Liver / pathology*
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Non-alcoholic Fatty Liver Disease / etiology*
  • Non-alcoholic Fatty Liver Disease / pathology
  • Non-alcoholic Fatty Liver Disease / therapy
  • Obesity / blood
  • Obesity / complications*
  • Obesity / epidemiology
  • Prevalence

Substances

  • Biomarkers
  • Dietary Carbohydrates