Recommendations developed for pediatric NAFLD
(HealthDay)—Evidence-based recommendations have been developed for screening, diagnosis, and treatment of pediatric nonalcoholic fatty liver disease (NAFLD). The guidelines were published online Nov. 30 in the Journal of Pediatric Gastroenterology and Nutrition.
Miriam B. Vos, M.D., M.S.P.H., from Emory University in Atlanta, and colleagues conducted a comprehensive literature review to make evidence-based recommendations for management of pediatric NAFLD.
The researchers included key recommendations relating to screening, diagnosis, treatment, and long-term care of NAFLD. NAFLD screening should be conducted in all obese children aged 9 to 11 years and in children with specific risk factors. Alanine aminotransferase can be used for screening. Diagnosis of NAFLD necessitates further testing to determine whether steatosis is present and assess causes. Liver biopsy may be needed to check for more advanced disease. Lifestyle changes are the first treatment option; weight loss may reduce fatty deposits. There is no evidence for benefits of medications or supplements for NAFLD. For some adolescents with severe obesity and related health conditions, weight-loss surgery may be considered. Ongoing care should include assessment of other obesity-related diseases and management of cardiovascular risk factors, avoidance of potential liver toxins, and awareness of possible psychosocial issues.
"[NAFLD] has rapidly evolved into the most common liver disease seen in the pediatric population and is a management challenge for general pediatric practitioners, subspecialists, and for health systems," the authors write.
Several authors disclosed financial ties to the biopharmaceutical industry.
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