An international multidisciplinary consensus on pediatric metabolic dysfunction-associated fatty liver disease

Authors

Le Zhang, Jiangnan University
Mortada El-Shabrawi, Faculty of Medicine
Louise A. Baur, The University of Sydney School of Medicine
Christopher D. Byrne, University of Southampton, Faculty of Medicine
Giovanni Targher, Università di Verona Scuola di Medicina e Chirurgia
Mohit Kehar, Children's Hospital of Eastern Ontario, Ottawa
Gilda Porta, Hospital Sirio-Libanês
Way Seah Lee, Universiti Malaya
Sander Lefere, Universiteit Gent
Serap Turan, Marmara Üniversitesi Tip Fakültesi
Anna Alisi, IRCCS Ospedale Pediatrico Bambino Gesù
Ram Weiss, Technion - Israel Institute of Technology
Maria Felicia Faienza, Università degli studi di Bari Aldo Moro
Ambika Ashraf, UAB Department of Pediatrics
Shikha S. Sundaram, University of Colorado Department of Pediatrics
Anshu Srivastava, Sanjay Gandhi Postgraduate Institute of Medical Sciences
Ruth De Bruyne, Universitair Ziekenhuis Gent
Yunkoo Kang, Yonsei University Wonju College of Medicine
Flora Bacopoulou, School of Medicine
Yong Hai Zhou, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University
Andy Darma, Universitas Airlangga
Monica Lupsor-Platon, Universitatea de Medicina si Farmacie Iuliu Hatieganu din Cluj-Napoca
Masahide Hamaguchi, Graduate School of Medical Science
Anoop Misra, Fortis-C-DOC Centre of Excellence for Diabetes
Nahum Méndez-Sánchez, Universidad Nacional Autónoma de México
Nicholas Beng Hui Ng, National University Hospital
Claude Marcus, Karolinska Institutet
Amanda E. Staiano, Pennington Biomedical Research Center
Nadia Waheed, Shaheed Zulfiqar Ali Bhutto Medical University
Saleh A. Alqahtani, King Faisal Specialist Hospital & Research Centre
Cosimo Giannini, University of G. d'Annunzio Chieti and Pescara
Ponsiano Ocama, School of Medicine, Makerere University College of Health Sciences
Mindie H. Nguyen, Stanford Healthcare
Maria Teresa Arias-Loste, Hospital Universitario Marqués de Valdecilla

Document Type

Article

Publication Date

7-12-2024

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in children and adolescents, particularly those with obesity. NAFLD is considered a hepatic manifestation of the metabolic syndrome due to its close associations with abdominal obesity, insulin resistance, and atherogenic dyslipidemia. Experts have proposed an alternative terminology, metabolic dysfunction-associated fatty liver disease (MAFLD), to better reflect its pathophysiology. This study aimed to develop consensus statements and recommendations for pediatric MAFLD through collaboration among international experts. Methods: A group of 65 experts from 35 countries and six continents, including pediatricians, hepatologists, and endocrinologists, participated in a consensus development process. The process encompassed various aspects of pediatric MAFLD, including epidemiology, mechanisms, screening, and management. Findings: In round 1, we received 65 surveys from 35 countries and analyzed these results, which informed us that 73.3% of respondents agreed with 20 draft statements while 23.8% agreed somewhat. The mean percentage of agreement or somewhat agreement increased to 80.85% and 15.75%, respectively, in round 2. The final statements covered a wide range of topics related to epidemiology, pathophysiology, and strategies for screening and managing pediatric MAFLD. Conclusions: The consensus statements and recommendations developed by an international expert panel serve to optimize clinical outcomes and improve the quality of life for children and adolescents with MAFLD. These findings emphasize the need for standardized approaches in diagnosing and treating pediatric MAFLD. Funding: This work was funded by the National Natural Science Foundation of China (82070588, 82370577), the National Key R&D Program of China (2023YFA1800801), National High Level Hospital Clinical Research Funding (2022-PUMCH-C-014), the Wuxi Taihu Talent Plan (DJTD202106), and the Medical Key Discipline Program of Wuxi Health Commission (ZDXK2021007).

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