Metabolic-Dysfunction Associated Steatotic Liver Disease (MASLD) in Children - A Review For Primary Care Pediatrics.

Metabolic-dysfunction associated steatotic liver disease (MASLD) is the new terminology given to the previous diagnosis of non-alcoholic fatty liver disease (NAFLD). It is the most common cause of liver disease in the pediatric population, with an increase in prevalence primarily due to the rise in the rate of obesity in children and adolescents. With the change in definition of NAFLD to MASLD, there was also a change in the diagnostic criteria, which no longer requires an elevation in liver enzymes. The severity of MASLD ranges from steatosis to metabolic dysfunctionassociated steatohepatitis (MASH), with the potential of progression to fibrosis, cirrhosis and hepatic failure. The mainstay of management is lifestyle modifications, including weight loss, dietary changes and increased physical activity, with medications having no proven benefit. This diagnosis remains a challenge for primary pediatricians, specialists and health-care systems, with further studies and recommendations needed to delineate screening and management of children with MASLD.