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With the growing obesity epidemic, NAFLD is now believed
to be the most common liver disease worldwide, affecting an estimated 10
percent of children and one-third of adults in the United States alone. The
most severe form of NAFLD, nonalcoholic steatohepatitis (NASH) affects 2-3
percent of all adults and children, but is found in approximately 25 percent of
children who have fatty liver. Up to one-quarter of patients with NASH may go
on to more severe fibrosis, cirrhosis and end-stage liver disease. Over the last decade, NASH has become the
third leading cause of liver transplantation in adults and severe scarring
(cirrhosis) can begin to develop in childhood and adolescence. Therefore, the goal is to identify children
and adolescents at risk for NAFLD and NASH, so that progression to cirrhosis
and end-stage liver disease can be prevented. The majority of patients with
pediatric NAFLD or NASH are overweight or obese, and many have associated
health problems, such as insulin resistance, diabetes mellitus, obstructive
sleep apnea, hypertension and dyslipidemia (features of metabolic syndrome). Achieving a healthier weight through better diet
and increased activity can be very successful in improving or resolving
NALFLD / NASH. Other treatments are also
being evaluated in clinical studies funded by the National Institutes of Health.
Comprehensive clinical care includes:
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