Metabolic dysfunction associated steatotic liver disease (MASLD), previously referred to as nonalcoholic fatty liver disease (NAFLD) and metabolic associated fatty liver disease (MAFLD), is increasingly prevalent among obese children and adolescents. It is associated with significant long-term health risks, including type 2 diabetes, cardiovascular disease, advanced liver conditions, and liver-related mortality. This systematic review analyzed 26 longitudinal studies with follow-up durations ranging from 4.5 to 39 years to investigate the persistence and progression of liver steatosis from childhood into adulthood and its associated complications. Prevalence data were derived from studies using varying diagnostic criteria, including NAFLD, MAFLD, and MASLD, which may reflect differences in patient populations due to distinct inclusion criteria. Diagnostic methods included imaging, liver biopsy, and biomarkers such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and genetic variants like patatin-like phospholipase domain-containing protein 3 (PNPLA3) and transmembrane 6 superfamily member 2 (TM6SF2). Despite its systemic impact, MASLD often progresses silently in pediatric populations with limited awareness among parents, affected children, and healthcare providers. Fragmented medical records and low follow-up rates further hinder effective management during the transition from pediatric to adult care. This review highlights the need for more comprehensive longitudinal research to better understand the progression of liver steatosis and its systemic effects. By synthesizing current evidence, it emphasizes the importance of early identification, timely intervention, and sustained care to mitigate long-term health consequences and improve outcomes.
Rey-Garcia et al. (Sun,) studied this question.