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
{"title":"An international multidisciplinary consensus on pediatric metabolic dysfunction-associated fatty liver disease.","authors":"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","doi":"10.1016/j.medj.2024.03.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Findings: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Funding: </strong>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).</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":null,"pages":null},"PeriodicalIF":12.8000,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Med","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.medj.2024.03.017","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/4/26 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
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).
期刊介绍：
Med is a flagship medical journal published monthly by Cell Press, the global publisher of trusted and authoritative science journals including Cell, Cancer Cell, and Cell Reports Medicine. Our mission is to advance clinical research and practice by providing a communication forum for the publication of clinical trial results, innovative observations from longitudinal cohorts, and pioneering discoveries about disease mechanisms. The journal also encourages thought-leadership discussions among biomedical researchers, physicians, and other health scientists and stakeholders. Our goal is to improve health worldwide sustainably and ethically.
Med publishes rigorously vetted original research and cutting-edge review and perspective articles on critical health issues globally and regionally. Our research section covers clinical case reports, first-in-human studies, large-scale clinical trials, population-based studies, as well as translational research work with the potential to change the course of medical research and improve clinical practice.
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