Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in children. NAFLD has emerged to\r\nbe extremely prevalent, and predicted by obesity and male gender. It is defined by hepatic fat infiltration >5%\r\nhepatocytes, in the absence of other causes of liver pathology. It includes a spectrum of disease ranging from\r\nintrahepatic fat accumulation (steatosis) to various degrees of necrotic inflammation and fibrosis\r\n(non-alcoholic steatohepatatis [NASH]). NAFLD is associated, in children as in adults, with severe metabolic\r\nimpairments, determining an increased risk of developing the metabolic syndrome. It can evolve to cirrhosis and\r\nhepatocellular carcinoma, with the consequent need for liver transplantation. Both genetic and environmental factors\r\nseem to be involved in the development and progression of the disease, but its physiopathology is not yet entirely\r\nclear. In view of this mounting epidemic phenomenon involving the youth, the study of NAFLD should be a priority for\r\nall health care systems. This review provides an overview of current and new clinical-histological concepts of pediatric\r\nNAFLD, going through possible implications into patho-physiolocical and therapeutic perspectives.
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