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Nichtalkoholische Fettlebererkrankung bei adipösen Kindern und Jugendlichen

Non-alcoholic fatty liver disease in obese children and adolescents

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz volume 56, pages 517–527 (2013)Cite this article

Zusammenfassung

Die nichtalkoholische Fettlebererkrankung (NAFLD) ist heute die häufigste Lebererkrankung bei Kindern und Jugendlichen in den industrialisierten Ländern. In Deutschland sind nach aktuellen Untersuchungen bis zu 30% der adipösen Kinder und Jugendlichen von einer NAFLD betroffen. Das Spektrum der NAFLD bei Kindern und Jugendlichen reicht von der einfachen Leberverfettung (Steatosis hepatis), über die Fettleberentzündung (Steatohepatitis) bis hin zu Fibrose und Zirrhose, d. h. Funktionsverlust des Lebergewebes. Alter, Geschlecht, Ethnizität, Insulinresistenz und Sexualhormone sind wichtige Faktoren in der Pathogenese einer NAFLD bei Kindern und Jugendlichen. Die NAFLD ist zudem bereits im Kindes- und Jugendalter mit erheblicher, frühmanifester kardiovaskulärer Komorbidität assoziiert. Die vorliegende Literaturübersicht fasst aktuelle Daten zur Epidemiologie, Pathophysiologie, Komorbidität und Therapie der NAFLD im Kindes- und Jugendalter zusammen.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in children and adolescents in industrialized countries. Recent studies have demonstrated a prevalence rate of NAFLD in overweight and obese children and adolescents in Germany of up to 30%. The spectrum of NAFLD ranges from pure fatty infiltration (simple steatosis) to inflammation (steatohepatitis, synonymous NASH) to fibrosis and cirrhosis. Age, gender, ethnicity, insulin resistance, and sex steroids are implicated in the pathogenesis of NAFLD in childhood and adolescence. Moreover, NAFLD in the pediatric age group is associated with marked cardiovascular comorbidities. This review focuses on current data regarding epidemiology, pathophysiology, comorbidities, and treatment of NAFLD in children and adolescents.

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  1. Sektion Pädiatrische Endokrinologie und Diabetologie, Universitätsklinik für Kinder und Jugendmedizin, Eythstr. 24, 89075, Ulm, Deutschland

    C. Denzer

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Denzer, C. Nichtalkoholische Fettlebererkrankung bei adipösen Kindern und Jugendlichen. Bundesgesundheitsbl. 56, 517–527 (2013). https://doi.org/10.1007/s00103-012-1639-4

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  • DOI: https://doi.org/10.1007/s00103-012-1639-4

Schlüsselwörter

  • Nichtalkoholische Fettlebererkrankung
  • Steatohepatitis
  • Adipositas im Kindes- und Jugendalter
  • Insulinresistenz
  • Viszerales Fettgewebe

Keywords

  • Non-alcoholic fatty liver disease
  • Non-alcoholic steatohepatitis
  • Childhood obesity
  • Insulin resistance
  • Visceral adipose tissue