Revised: November 26, 2013
Accepted: December 9, 2013
Published online: January 27, 2014
Fatty liver is a growing health problem worldwide. It might evolve to nonalcoholic steatohepatitis, cirrhosis and cause hepatocellular carcinoma. This disease, which has increased because of eating habits, changes in food content and lifestyle, affects people from childhood. The most important risk factors are obesity and insulin resistance. Besides these factors, gender, ethnicity, genetic predisposition and some medical problems are also important. Cirrhosis in children is rare but is reported. Nonalcoholic fatty liver disease (NAFLD) has no specific symptoms or signs but should be considered in obese children. NAFLD does not have a proven treatment. Weight loss with family based treatments is the most acceptable management. Exercise and an applicable diet with low glycemic index and appropriate calorie intake are preferred. Drugs are promising but not sufficient in children for today.
Core tip: Nonalcoholic fatty liver disease (NAFLD) consists of steatosis in liver, steatohepatitis and cirrhosis. Histological type 2 pattern (macrovesicular steatosis with portal inflammation and/or fibrosis, generally without evidence of cellular injury or lobular inflammation) is seen differently in children than in adults. The most important risk factors are obesity and insulin resistance, as well as gender, ethnicity, genetic predisposition and some medical problems. Progression to cirrhosis in children is rare but possible. NAFLD does not have a proven treatment. Losing weight and increasing physical activity provide improvement in histological and biochemical findings in fatty liver. Drugs are used in specific situations. More research is needed for drug therapy.