ArticleHepatology (Baltimore, Md.)2025
Longitudinal response to standard of care in pediatric metabolic dysfunction-associated steatotic liver disease: Rates of improvement and worsening, and factors associated with outcomes.
Article in Hepatology (Baltimore, Md.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Alcohol use trajectories and liver enzyme changes in adolescents with MASLD: A longitudinal multicenter cohort.Hepatology communications · 2026Article
- Outcome of Targeted Therapy for Obstructive Sleep Apnea in Children with Obesity and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Children (Basel, Switzerland) · 2026Article
- Global epidemiological patterns and disease burden of metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction and alcohol-associated liver disease, and alcohol-associated liver disease.Clinical and molecular hepatology · 2026Review
- European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) steatotic liver disease special interest group position paper on screening, diagnosis and investigation of paediatric metabolic dysfunction-associated steatotic liver disease.Journal of pediatric gastroenterology and nutrition · 2026Article
- Weight Loss and Metabolic Remission in Obese Children with MASLD: Reflections on the Use of ALT and Cohort Selection.Indian pediatrics · 2026Article
- Longitudinal performance of vibration controlled transient elastography in pediatric metabolic dysfunction associated steatotic liver disease.Journal of pediatric gastroenterology and nutrition · 2026Article
- Fighting the epidemic of pediatric metabolic dysfunction-associated steatotic liver disease: Role of non-invasive diagnostics and early pharmacological intervention.World journal of hepatology · 2026Review
- Burden of metabolic dysfunction-associated steatotic liver disease in the Asia-Pacific region from 1990 to 2023.eGastroenterology · 2026Article
- Pediatric MASLD in China: epidemiology, screening, diagnosis, and management.The Lancet regional health. Western Pacific · 2025Review
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Authors and funding
11 authors.
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Abstract
BACKGROUND AND
aimsLongitudinal outcomes in children with metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear due to the absence of a standardized monitoring approach. This study aimed to (1) define improvement and worsening in children with MASLD, (2) estimate rates of improvement or deterioration with the standard of care (SOC) over 1 and 2 years, and (3) identify baseline and longitudinal factors associated with improvement or worsening. APPROACH AND
resultsUsing data from 2 large randomized controlled trials, we derived definitions for composite improvement and worsening of MASLD based on associations between changes in ALT, GGT, and liver histology after 1 and 2 years. Improvement was defined as ≥40% decrease in ALT and ≥20% decrease in GGT and worsening as ≥20% increase in both ALT and GGT. We applied definitions to a cohort of 440 children with MASLD. After 1 year of SOC, 22% of children with MASLD showed improvement, increasing to 31% after 2 years. However, 20% showed worsening after both 1 and 2 years despite receiving SOC. Logistic regression analysis, employing stepwise model selection, identified changes in body mass index z-score and cholesterol to be most associated with improvement or deterioration.
conclusionsThis study developed criteria for improvement and worsening in children with MASLD over 1 and 2 years of follow-up. With SOC, over one-quarter of children are likely to improve while one-fifth of children are likely to worsen. Targeting interventions that affect body mass index and lipid parameters may help improve MASLD over time.
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