Epidemiology and Natural History of Nafld/Epidemiologija I Prirodna Istorija Nealkoholne Masne Jetre

Open access


Paralleling the growing prevalence of obesity and metabolic syndrome, nonalcoholic fatty liver disease (NAFLD) is emerging as the most frequent hepatopathy in adults and children. The true prevalence of pediatric NAFLD is still unknown, because of the heterogeneity of diagnostic methods used for diagnosis in the available studies and the different characteristics of the populations evaluated. Pediatric NAFLD is typically of primary origin and it is strongly associated with several features of the metabolic syndrome. Age, gender and race/ethnicity are significant determinants of risk, and sex hormones, insulin sensitivity and adipocytokines are implicated in the pathogenesis of pediatric NAFLD. The natural history of NAFLD in children is still poorly understood, because of its complex nature and the scarcity of prospective studies, especially in pediatric populations. Both genetic and environmental factors seem to be implicated in the development and progression of the disease via multiple mechanisms that involve liver crosstalk with other organs and tissues, especially gut and adipose tissue. To evaluate and effectively treat pediatric NAFLD, the pathophysiology and natural history of the disease should be clarified and noninvasive methods for screening, diagnosis, and longitudinal assessment developed.

1. Brunt EM. Pathology of nonalcoholic fatty liver disease. Nat Rev Gastroenterol Hepatol 2010; 7: 195-203.

2. Feldstein AE, Charatcharoenwitthaya P, Treeprasertsuk S, Benson JT, Enders FB, Angulo P. The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years. Gut 2009; 58: 1538-44.

3. Vajro P, Lenta S, Socha P, Dhawan A, McKiernan P, Baumann U, et al. Diagnosis of nonalcoholic fatty liver disease in children and adolescents: position paper of the ESPGHAN Hepatology Committee. J Pediatr Gastro - enterol Nutr 2012; 54: 700-13.

4. Adams LA, Feldstein AE. Non-invasive diagnosis of nonalcoholic fatty liver and nonalcoholic steatohepatitis. J Dig Dis 2011; 12: 10-16.

5. Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, et al. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology 2010; 51: 121-9.

6. Thoma C, Day CP, Trenell MI. Lifestyle interventions for the treatment of non-alcoholic fatty liver disease in adults: A systematic review. J Hepatol 2011; 56: 255-66.

7. Socha P, Horvath A, Vajro P, Dziechciarz P, Dhawan A, Szajewska H. Pharmacological interventions for nonalcoholic fatty liver disease in adults and in children: a systematic review. J Pediatr Gastroenterol Nutr 2009; 48: 587-96.

8. Bellentani S, Scaglioni F, Marino M, Bedogni G. Epide - miology of Fatty Liver Disease. Dig Dis 2010; 28: 155-61.

9. Browning JD, Szczepaniak LS, Dobbins R, Nuremberg P, Horton JD, Cohen JC, et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology 2004; 40: 1387-95.

10. Franzese A, Vajro P, Argenziano A, Puzziello A, Iannucci MP, Saviano MC, et al. Liver involvement in obese children. Ultrasonography and liver enzyme levels at diagnosis and during follow-up in an Italian population. Dig Dis Sci 1997; 42: 1428-32.

11. Siegelman ES, Rosen MA. Imaging of hepatic steatosis. Semin Liver Dis 2001; 21: 71-80.

12. Strauss S, Gavish E, Gottlieb P, Katsnelson L. Inter obser - ver and intraobserver variability in the sonographic assessment of fatty liver. AJR 2007; 189: W320-W323.

13. Mottin CC, Moretto M, Padoin AV, Swarowsky AM, Toneto MG, Glock L, Repetto G. The role of ultrasound in the diagnosis of hepatic steatosis in morbidly obese patients. Obes Surg 2004; 14: 635-7.

14. Loomba R, Sirlin CB, Schwimmer JB, Lavine JE. Advances in pediatric nonalcoholic fatty liver disease. Hepatology 2009; 50: 1282-93.

15. Strauss RS, Barlow SE, Dietz WH. Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents. J Pediatr 2000; 136: 727-33.

16. Park HS, Han JH, Choi KM, Kim SM. Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean adolescents. Am J Clin Nutr 2005; 82: 1046-51.

17. Tominaga K, Kurata JH, Chen YK, Fujimoto E, Miyagawa S, Abe I, et al. Prevalence of fatty liver in Japanese children and relationship to obesity. An epidemiological ultrasonographic survey. Dig Dis Sci 1995; 40: 2002-9.

18. Chan DF, Li AM, Chu WC, Chan MH, Wong EM, Liu EK, Chan IH, et al. Hepatic steatosis in obese Chinese children. Int J Obes Relat Metab Disord 2004; 28: 1257-63.

19. Schwimmer JB, Deutsch R, Kahen T, Lavine JE, Stanley C, Behling C. Prevalence of fatty liver in children and adolescents. Pediatrics 2006; 118: 1388-93.

20. Schwimmer JB, McGreal N, Deutsch R, Finegold MJ, Lavine JE. Influence of gender, race, and ethnicity on suspected fatty liver in obese adolescents. Pediatrics 2005; 115: e561-5.

21. Nobili V, Reale A, Alisi A, Morino G, Trenta I, Pisani M, et al. Elevated serum ALT in children presenting to the emergency unit: relationship with NAFLD. Dig Liver Dis 2009; 41: 749-52.

22. Huang SC, Yang YJ. Serum retinol-binding protein 4 is independently associated with pediatric NAFLD and fasting triglyceride level. J Pediatr Gastroenterol Nutr 2013; 56: 145-50.

23. Nobili V, Donati B, Panera N, Vongsakulyanon A, Alisi A, Dallapiccola B, et al. A Four-Polymorphisms Risk Score Predicts Steatohepatitis In Children With Non-Alcoholic Fatty Liver Disease. J Pediatr Gastroenterol Nutr 2013; Dec 16 (in press).

24. Nobili V, Liccardo D, Bedogni G, Salvatori G, Gnani D, Bersani I, et al. Influence of dietary pattern, physical activity, and I148M PNPLA3 on steatosis severity in atrisk adolescents. Genes Nutr 2014; 9: 392.

25. Liou I, Kowdley KV. Natural history of nonalcoholic steatohepatitis. J Clin Gastroenterol 2006; 40 Suppl 1: S11-S16.

26. Guha IN, Parkes J, Roderick PR, Harris S, Rosenberg WM. Noninvasive markers associated with liver fibrosis in nonalcoholic fatty liver disease. Gut 2006; 55: 1650-60.

27. Schwimmer JB, Deutsch R, Rauch JB, Behling C, Newbury R, Lavine JE. Obesity, insulin resistance, and other clinicopathological correlates of pediatric nonalcoholic fatty liver disease. J Pediatr 2003; 143: 500-5.

28. Dujić T, Bego T, Mlinar B, Semiy S, Malenica M, Prnja - vorac B, Ostanek B, Marc J, ^au{ević A. Effects of the PPARG gene polymorphisms on markers of obesity and metabolic syndrome in Bosnian subjects. J Med Biochem 2014; 33: 323-32.

29. Barshop NJ, Sirlin CB, Schwimmer JB, Lavine JE. Review article: epidemiology, pathogenesis and potential treatments of paediatric non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2008; 28: 13-24.

30. Kohli R, Boyd T, Lake K, Dietrich K, Nicholas L, Balistreri WF, et al. Rapid progression of NASH in childhood. J Pediatr Gastroenterol Nutr 2010; 50: 453-6.

Journal of Medical Biochemistry

The Journal of Society of Medical Biochemists of Serbia

Journal Information

IMPACT FACTOR 2017: 1.378
5-year IMPACT FACTOR: 0.704

CiteScore 2017: 1.05

SCImago Journal Rank (SJR) 2017: 0.307
Source Normalized Impact per Paper (SNIP) 2017: 0.532

Cited By


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 118 118 15
PDF Downloads 50 50 5