Nichtalkoholische Fettleber bei Kindern und Jugendlichen

Zusammenfassung

Die nichtalkoholische Fettleber ist die häufigste chronische Lebererkrankung im Kindes- und Jugendalter und ist oft mit Adipositas und Diabetes mellitus Typ 2 assoziiert. Der Begriff „Nichtalkoholische Fettleber-Erkrankung“, kurz NAFLD („nonalcoholic fatty liver disease“), beinhaltet ein Erkrankungsspektrum reichend von Fettleber mit fehlender Progression bis hin zur nichtalkoholischen Steatohepatitis (NASH). Bildgebende Verfahren und laborchemische Parameter helfen bei der primären Beurteilung und zur Verlaufsbegutachtung – für die Prognose ausschlagegebend ist die Histologie der Leberbiopsie. Die Therapie von NAFLD beschränkt sich primär auf Änderungen des Lebensstils und der Ernährung, die bariatrische Therapie wird zunehmend angewendet.

Summary

In recent years nonalcoholic fatty liver disease (NAFLD) has become the most prevalent form of chronic liver disease worldwide; it is estimated to afflict 80–90 % of obese and diabetic children. NAFLD in children covers a spectrum from simple steatosis through steatohepatitis (NASH) to progressive hepatic fibrosis, leading to cirrhosis and ultimately hepatic failure at an older age. Assessment of fibrosis and its severity in NAFLD is central for prognosis and therapeutic intervention. Currently, liver biopsy is the most sensitive method to differentiate stages in NAFLD. Diet and exercise have been a focus of treatment for NAFLD and NASH due to the association with obesity and type-2-diabetes.

Schlüsselwörter

Nichtalkoholische Fettleber - Adipositas - Steatosis hepatitis - metabolisches Syndrom

Keywords

Nonalcoholic fatty liver disease - adipositas - steatosis hepatitis - metabolic syndrom

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