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

  • Le Zhang
  • , Mortada El-Shabrawi
  • , Louise A. Baur
  • , Christopher D. Byrne
  • , Giovanni Targher
  • , Mohit Kehar
  • , Gilda Porta
  • , Way Seah Lee
  • , Sander Lefere
  • , Serap Turan
  • , Anna Alisi
  • , Ram Weiss
  • , Maria Felicia Faienza
  • , Ambika Ashraf
  • , Shikha S. Sundaram
  • , Anshu Srivastava
  • , Ruth De Bruyne
  • , Yunkoo Kang
  • , Flora Bacopoulou
  • , Yong Hai Zhou
  • Andy Darma, Monica Lupsor-Platon, Masahide Hamaguchi, Anoop Misra, Nahum Méndez-Sánchez, Nicholas Beng Hui Ng, Claude Marcus, Amanda E. Staiano, Nadia Waheed, Saleh A. Alqahtani, Cosimo Giannini, Ponsiano Ocama, Mindie H. Nguyen, Maria Teresa Arias-Loste, Mohamed Rabea Ahmed, Giada Sebastiani, Yong Poovorawan, Mamun Al Mahtab, Juan M. Pericàs, Themis Reverbel da Silveira, Peter Hegyi, Amer Azaz, Hasan M. Isa, Chatmanee Lertudomphonwanit, Mona Issa Farrag, Ahmed Abd Alwahab Nugud, Hong Wei Du, Ke Min Qi, Nezha Mouane, Xin Ran Cheng, Tawfiq Al Lawati, Eleonora D.T. Fagundes, Hasmik Ghazinyan, Adamos Hadjipanayis, Jian Gao Fan, Nicoleta Gimiga, Naglaa M. Kamal, Gabriela Ștefănescu, Li Hong, Smaranda Diaconescu, Ming Li, Jacob George, Ming Hua Zheng

Research output: Contribution to journalArticlepeer-review

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).

Original languageEnglish (US)
Pages (from-to)797-815.e2
JournalMed
Volume5
Issue number7
DOIs
StatePublished - Jul 12 2024

Keywords

  • MAFLD
  • MASLD
  • Translation to population health
  • adolescents
  • children
  • consensus
  • metabolic dysfunction-associated fatty liver disease
  • non-alcoholic fatty liver disease

ASJC Scopus subject areas

  • General Medicine

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