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Pediatric non-alcoholic fatty liver disease: New insights and future directions
Pierluigi Marzuillo, Emanuele Miraglia del Giudice, Nicola Santoro
Pierluigi Marzuillo, Emanuele Miraglia del Giudice, Department of women and children and General and Specialized Surgery, Seconda Università degli Studi di Napoli, 80138 Naples, Italy
Nicola Santoro, Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06520, United States
Author contributions: All the authors conceived and wrote the manuscript.
Supported by The American Heart Association (AHA), No. 13SDG14640038; 2012 Yale Center for Clinical Investigation (YCCI) scholar award to Santoro N; CTSA Grant Number UL1 RR024139 from the National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health (NIH), and NIH roadmap for Medical Research
Correspondence to: Nicola Santoro, MD, PhD, Department of Pediatrics, Yale University School of Medicine, 330 Cedar Street, P.O. Box 208064, New Haven, CT 06520, United States. email@example.com
Telephone: +1-203-7376356 Fax: +1-203-7856421
Received: October 17, 2013 Revised: February 25, 2014 Accepted: March 17, 2014 Published online: April 27, 2014
Core tip: The prevalence of hepatic steatosis is increased in the last three decades concomitantly with the increased prevalence of pediatric obesity. Non-alcoholic fatty liver disease (NAFLD) is the most common form of liver disease in children. The PNPLA3 rs738409 and the glucokinase regulatory protein rs1260326 are the strongest variants associated with fatty liver in paediatrics. Important risk factors are obesity, insulin resistence, gender, ethnicity and excessive dietetic intake of n-6 polyunsatured fatty acids and fructose. New pharmacological approaches are object of study, in NAFLD children poorly adherent to or being unresponsive/partially responsive to lifestyle changes.