Pediatric non-alcoholic fatty liver disease: Recent solutions, unresolved issues, and future research directions

Table 1 Non-invasive diagnostic tests of non-alcoholic fatty liver disease

Hepatic fibrosis scores	Advanced biochemical markers	Newly proposed markers
AST/ALT ratio	Cytokeratin 18 fragment levels (CK-18)	Serum potassium
Platelet ratio index (APRI)	Extracellular matrix turnover biomarkers:	Soluble Fas and Fas Ligand (sFasL)
Fibrosis (FIB)-4 index	Enhanced liver fibrosis (ELF) test	Plasma catepsin D (CatD)
NAFLD Fibrosis score (NFS)	Amino-terminal propeptide III procollagen (PIIINP)	Circulating zonulin
Pediatric NAFLD fibrosis score	Hyaluronic acid (HA)	Adipokines (e.g., chemerin)
		Serum Uric Acid (UA)
		Vitamin D
		Proteomics signature
		Metabolomic signature

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; NAFLD: Non-alcoholic fatty liver disease.