Nonalcoholic Fatty Liver Disease/Non-Alcoholic Steatohepatitis in Childhood: Endocrine-Metabolic “Mal-Programming”


Sara Manti 1 , Claudio Romano 1 , Valeria Chirico 1 , Martina Filippellii 1 , Caterina Cuppari 1 , Italia Loddo 1 , Carmelo Salpietro 1 , Teresa Arrigo 1 , *

1 Department of Pediatric Sciences, Genetics and Pediatric Immunology Unit, University of Messina, Messina, Italy

How to Cite: Manti S, Romano C, Chirico V, Filippellii M, Cuppari C, et al. Nonalcoholic Fatty Liver Disease/Non-Alcoholic Steatohepatitis in Childhood: Endocrine-Metabolic “Mal-Programming”, Hepat Mon. 2014 ; 14(5):e93068. doi: 10.5812/hepatmon.17641.


Hepatitis Monthly: 14 (5); e93068
Published Online: May 01, 2014
Article Type: Review Article
Received: May 06, 2019
Accepted: February 19, 2014




Context: Nonalcoholic Fatty Liver Disease (NAFLD) is the major chronic liver disease in the pediatric population. NAFLD includes a broad spectrum of abnormalities (inflammation, fibrosis and cirrhosis), ranging from accumulation of fat (also known as steatosis) towards non-alcoholic steatohepatitis (NASH). The development of NAFLD in children is significantly increased.

Evidence Acquisition: A literature search of electronic databases was undertaken for the major studies published from 1998 to today. The databases searched were: PubMed, EMBASE, Orphanet, Midline and Cochrane Library. We used the key words: "non-alcoholic fatty liver disease, children, non-alcoholic steatohepatitis and fatty liver".

Results: NAFLD/NASH is probably promoted by “multiple parallel hits”: environmental and genetic factors, systemic immunological disorders (oxidative stress, persistent-low grade of inflammation) as well as obesity and metabolic alterations (insulin resistance and metabolic syndrome). However its exact cause still underdiagnosed and unknown.

Conclusions: Pediatric NAFLD/NASH is emerging problem. Longitudinal follow-up studies, unfortunately still insufficient, are needed to better understand the natural history and outcome of NAFLD in children. This review focuses on the current knowledge regarding the epidemiology, pathogenesis, environmental, genetic and metabolic factors of disease. The review also highlights the importance of studying the underlying mechanisms of pediatric NAFLD and the need for complete and personalized approach in the management of NAFLD/NASH.


Non-Alcoholic Fatty Liver Disease Mallory Bodies Oxidative Stress

© 2014, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.



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