ABSTRACT
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in children and adolescents.1 NAFLD encompasses a spectrum of diseases, from isolated steatosis to steatohepatitis and fibrosis. Histological examination is required for definitive diagnosis of NAFLD. Though NAFLD is often suspected in obese children with elevated liver enzymes, it is important to recognize that obesity and NAFLD are not necessarily concomitant. In fact, NAFLD is present in only a minority of children with obesity. However, obese children with NAFLD are at a higher risk of morbidity and mortality. NAFLD also occurs in nonobese children, with average estimates of ~5% prevalence of NAFLD in normal-weight children.2-4 The pathophysiology of NAFLD, though still incompletely understood, is multifactorial. This chapter highlights pediatric NAFLD (epidemiology, diagnostic approaches, pathophysiology, the impact of NAFLD, and emerging treatments) and more closely examines the relationship between obesity and NAFLD in children.
