Treatment of nonalcoholic fatty liver disease in children
Nutritional Therapy Metabolism 2011; 29(4): 157 - 167
Article Type: REVIEW
Tudor Lucian Pop, Ana Stefanescu, Nicolae Miu
- Tudor Lucian Pop
- Second Pediatric Clinic, Iuliu Haţieganu University of Medicine and Pharmacy
- 5, Crisan str.
- 400177 Cluj-Napoca
Nonalcoholic fatty liver disease has recently become the most frequent cause of chronic liver damage in children, with potential progression towards fibrosis and cirrhosis. The children sometimes complain of abdominal pain, fatigue or malaise, may have hepatomegaly with or without splenomegaly, or may be asymptomatic and laboratory and ultrasound changes are found incidentally or after screening for obesity-related comorbidities; more than 90% of children with nonalcoholic fatty liver disease are obese with central obesity. The diagnosis for nonalcoholic fatty liver disease requires a clinical and histological algorithm.
At present there are no standard recommendations for the treatment of nonalcoholic fatty liver disease. The therapeutic strategies for these patients can be divided into three categories: identification and treatment of metabolic associations (obesity, diabetes mellitus and dyslipidemia); improving insulin resistance through weight loss, physical exercise or drug therapy; and protecting the liver from oxidative stress by using hepatoprotector agents (antioxidants). The treatment of pediatric nonalcoholic fatty liver disease has two goals: to reverse liver disease and to promote healthy growth. The safest treatment choice for children with nonalcoholic fatty liver disease remains diet and regular physical activity. Before the use of drugs, some of which proven effective in adults, can be recommended, new controlled studies assessing their effectiveness and safety in children are necessary.
- • Submitted on 9/1/2011
- • Accepted on 11/23/2011
- • Available online on 9/18/2012
Conflict of interest statement: none declared.
Financial support: none.
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