The American Academy of Pediatrics has endorsed new guidelines recommending the screening of all obese children aged 9 to 11 for non-alcoholic fatty liver disease (NAFLD).
The guidelines were developed by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), and also include recommendations for diagnosis, treatment, and follow-up care of children and adolescents with NAFLD.
Some of the key recommendations include:
• Screening: using a simple liver enzyme test (alanine aminotransferase, or ALT).
• Diagnosis: Further tests are needed to determine a diagnosis, this may include obtaining a sample of liver tissue to check for more advanced disease.
• Treatment: There are no current medications proven to benefit NAFLD, thus improving diet and exercise are the first steps in treatment. Bariatric surgery may be considered for some with severe obesity.
• Long-term care: this includes managing cardiovascular risk factors, avoidance of liver toxins and being alert for possible psychosocial issues in children with NAFLD.
The recommendations were made after comprehensive review by the NASPGHAN expert committee. Studies suggest that up to 38% of obese children and adolescents may have NAFLD, and the disease is known to have many related conditions, such as diabetes and sleep apnea.
The committee demanded more high-quality studies of strategies for prevention, screening, diagnosis, and treatment of NAFLD in pediatric patients.
The guidelines are published in full in the Journal of Pediatric Gastroenterology and Nutrition.
For more information visit journals.lww.com.