Pediatric non-alcoholic fatty liver disease: Preventive and therapeutic value of lifestyle intervention

被引:64
作者
Nobili, Valerio [1 ]
Alisi, Anna [1 ]
Raponi, Massimiliano [2 ]
机构
[1] Bambino Gesu Pediat Hosp, Liver Unit, Res Inst, I-00165 Rome, Italy
[2] Bambino Gesu Pediat Hosp, Hlth Planning Dept, Res Inst, I-00165 Rome, Italy
关键词
Fatty liver; Children; Lifestyle; Diet; Exercise; Prevention; OBESE CHILDREN; URSODEOXYCHOLIC ACID; INSULIN-RESISTANCE; VITAMIN-E; CONTROLLED-TRIAL; TNF-ALPHA; STEATOHEPATITIS; NASH; METABOLISM; ROSIGLITAZONE;
D O I
10.3748/wjg.15.6017
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Nonalcoholic fatty liver disease (NAFLD), ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), and eventually cirrhosis and liver failure, is seen to be increasing amongst Western children. NAFLD rates are rising in parallel with the epidemic of childhood obesity, and in particular, fatty liver evolves more easily in NASH when poor dietary habits and sedentary lifestyle are combined. In fact, its general prevalence in the child population varies between 2.6% and 10%, but increases up to 80% in obese children. Since NASH is expected to become the most common cause of pediatric chronic liver disease in the near future, there is broad interest amongst clinical researchers to move forward, both in diagnosis and treatment. Unfortunately, to date, the expensive and invasive procedure of liver biopsy is seen as the gold standard for NASH diagnosis and few noninvasive diagnostic methods can be applied successfully. Moreover, there are still no approved pharmacological interventions for NAFLD/NASH. Therefore, current management paradigms are based upon the presence of associated risk factors and aims to improve an individual's quality of life, thus reducing NAFLD-associated morbidity and mortality. Today, lifestyle intervention (diet and exercise) is the treatment of choice for NAFLD/NASH. Thus far, no study has evaluated the potential preventive effect of lifestyle intervention on children at risk of NAFLD/NASH. Future studies will be required in this area with the perspective of developing a national program to promote nutrition education and increase physical activity as means of preventing the disease in individuals at risk. Here, we outline the clinical course, pathogenesis and management of NAFLD in children, highlighting the preventive and therapeutic value of lifestyle intervention. (C) 2009 The WJG Press and Baishideng. All rights reserved.
引用
收藏
页码:6017 / 6022
页数:6
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