Yodoshi T. Exploring non-invasive diagnostics and non-imaging approaches for pediatric metabolic dysfunction-associated steatotic liver disease. World J Gastroenterol 2024; 30(47): 5070-5075 [PMID: 39713163 DOI: 10.3748/wjg.v30.i47.5070]
Corresponding Author of This Article
Toshifumi Yodoshi, MD, PhD, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Ontario, Canada. toshifumi.yodoshi@sickkids.ca
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 21, 2024; 30(47): 5070-5075 Published online Dec 21, 2024. doi: 10.3748/wjg.v30.i47.5070
Exploring non-invasive diagnostics and non-imaging approaches for pediatric metabolic dysfunction-associated steatotic liver disease
Toshifumi Yodoshi
Toshifumi Yodoshi, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto M5G 1X8, Ontario, Canada
Author contributions: Yodoshi T contributed to the concept, design, manuscript writing, and editing, as well as the review of the literature.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshifumi Yodoshi, MD, PhD, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, 555 University Ave, Toronto M5G 1X8, Ontario, Canada. toshifumi.yodoshi@sickkids.ca
Received: July 30, 2024 Revised: October 16, 2024 Accepted: November 7, 2024 Published online: December 21, 2024 Processing time: 118 Days and 9.6 Hours
Abstract
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.
Core Tip: This article reviews non-invasive diagnostic approaches and liver fibrosis assessment methods for pediatric metabolic dysfunction-associated steatotic liver disease (MASLD), highlighting the recent nomenclature change and the significance of early diagnosis. MASLD is the most common chronic liver disease in children, with approximately half of the pediatric cases progressing to metabolic dysfunction-associated steatohepatitis at diagnosis and already having comorbidities such as renal disease, sarcopenia, hypertension, and type 2 diabetes mellitus. While liver biopsy is the gold standard for diagnosing MASLD, it is invasive. To avoid liver biopsy in children, developing non-invasive methods such as biomarkers, serum tests, and imaging is essential.
