Adipositas - Ursachen, Folgeerkrankungen, Therapie 2017; 11(01): 28-32
DOI: 10.1055/s-0037-1618947
Übersichtsarbeit
Schattauer GmbH

Fettlebererkrankung bei Kindern und Jugendlichen

Ein unterschätztes Problem mit schwerwiegenden KomplikationenFatty liver disease in children and adolescentsAn underestimated problem with serious complications
M. Penke
1   Universitätklinikum Leipzig, Department für Frauenund Kindermedizin, Leipzig, Germany; Leiter: Prof. Dr. Wieland Kiess
,
S. Schuster
1   Universitätklinikum Leipzig, Department für Frauenund Kindermedizin, Leipzig, Germany; Leiter: Prof. Dr. Wieland Kiess
2   University of California San Diego, School of Medicine, Department of Pediatrics, La Jolla, USA; Leiter: Prof. Dr. Ariel Feldstein
,
N. Händel
1   Universitätklinikum Leipzig, Department für Frauenund Kindermedizin, Leipzig, Germany; Leiter: Prof. Dr. Wieland Kiess
,
W. Kiess
1   Universitätklinikum Leipzig, Department für Frauenund Kindermedizin, Leipzig, Germany; Leiter: Prof. Dr. Wieland Kiess
,
G. Flemming
1   Universitätklinikum Leipzig, Department für Frauenund Kindermedizin, Leipzig, Germany; Leiter: Prof. Dr. Wieland Kiess
› Author Affiliations
Further Information

Publication History

Publication Date:
29 December 2017 (online)

Zusammenfassung

Die nicht-alkoholbedingte Fettlebererkrankung (NAFL) ist selbst bei Kindern und Jugendlichen eine der häufigsten chronischen Lebererkrankungen in den westlichen Industriestaaten. NAFL ist assoziiert mit Übergewicht, kardiovaskulären Erkrankungen oder Typ-2-Diabetes. Die Kombination von Risikofaktoren, wie z.B. Übergewicht, ungünstige Ernährungsgewohnheiten, Umweltfaktoren und genetische Prädisposition, führt zur Entwicklung einer einfachen Steatose im Kindes- und Jugendalter, die sich im weiteren Verlauf zur Steatohepatitis, Leberfibrose und Zirrhose entwickeln kann. Als wichtigste Voraussetzung, um eine NAFL im Kindes- und Jugendalter festzustellen, muss diese Diagnose überhaupt in Betracht gezogen werden. Erste Hinweise geben dabei erhöhte Alanin-Aminotransferase-Spiegel und eine generalisierte Echogenitätsanhebung in der Leberultraschalluntersuchung. Die histologische Begutachtung einer Leberbiopsie stellt den Goldstandard der NAFL-Diagnostik dar. Die Therapie sollte in Abhängigkeit von weiteren Komorbiditäten des Patienten, wie z.B. Hyperlipidämie oder Insulinresistenz individuell abgestimmt werden, um Spätfolgen im Erwachsenenalter möglichst früh entgegenzuwirken.

Summary

Non-alcoholic fatty liver disease (NALFD) is one of the most common chronic liver diseases in western countries, even in children and adolescents. NAFLD is associated with e.g. overweight, cardiovascular diseases or type 2 diabetes. Risk factors such as overweight, poor eating habits, environmental factors and genetic predisposition lead to simple steatosis in children and adolescents which can further progress to steatohepatitis, fibrosis or cirrhosis. Considering NAFLD as a potential differential diagnosis in children and adolescents is a key in the assessment of pediatric liver disorders. High serum alanineaminotransferase levels and suspect ultrasound scan might be first signs of NAFLD. Histological examination of a liver biopsy is considered the gold standard in the diagnosis of NAFLD. Therapy options should be selected individually and depend on comorbidities such as hyperlipidemia or insulin resistance to avoid long-term effects in adulthood.

 
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