Exploring non-invasive diagnostics and non-imaging approaches for pediatric metabolic dysfunction-associated steatotic liver disease.

In this article, we comment on the article by Qu and Li, focusing specifically on the non-invasive diagnostic approaches for metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD is the most common chronic liver disease in children. Nearly half of pediatric MASLD cases progress to metabolic dysfunction-associated steatohepatitis at diagnosis, often with comorbidities like renal disease, hypertension, type 2 diabetes, and mental health disorders. Early diagnosis and continuous intervention are crucial for managing this "silent organ" disease. Screening is recommended for children aged nine and older with obesity. Liver biopsy remains the diagnostic gold standard; however, due to its invasiveness, non-invasive methods - biomarkers, anthropometric algorithms, serum tests, and imaging - are increasingly vital. This editorial provides an overview of the current non-invasive diagnostic approaches for pediatric MASLD or liver fibrosis.