An international multidisciplinary consensus on pediatric metabolic dysfunction-associated fatty liver disease

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, such as metabolic dysfunction-associated fatty liver disease (MAFLD), to better reflect its pathophysiology.

Objective: 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.

Results: in Round 1, we received 65 surveys from 35 countries and analyzed these results, which informed that 73.3% of respondents agreed with 20 draft statements, 23.8% somewhat agreed. The mean percentage of agreement or somewhat agreement has increased to 80.85% and 15.75% in Round 2. The final statements covered a wide range of topics related to epidemiology, pathophysiology, and strategies for screening and managing pediatric MAFLD.

Conclusion: 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.

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Identifiers

ORCID for Christopher D. Byrne: orcid.org/0000-0001-6322-7753

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