{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:34:12Z","timestamp":1789576452813,"version":"build-2803163510"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T00:00:00Z","timestamp":1650931200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatol Commun"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Recently, an expert panel proposed diagnostic criteria for metabolic dysfunction\u2013associated fatty liver disease (MAFLD) in the pediatric population. The aim of this study was to evaluate the prevalence of MAFLD among US adolescents and to investigate whether the new MAFLD definition is able to identify individuals with more advanced liver disease. We analyzed data from participants 12\u201318\u2009years old included in the 2017\u20132020\u2009cycles of the National Health and Nutrition Examination Survey, a large survey aimed at including individuals representative of the non\u2010institutionalized general US population. Participants with a complete vibration\u2010controlled transient elastography exam were included. Steatosis was evaluated through the median controlled attenuation parameter (CAP) and fibrosis through median liver stiffness measurement (LSM). Recently proposed criteria for the diagnosis of MAFLD were applied. Multivariable logistic regression analysis was performed to evaluate the impact of the new MAFLD definition on the odds of significant liver fibrosis. We included a total of 1446 adolescents (mean age: 14.9\u2009years; 52.0% male; 47.3% overweight or obese). No participant reported a previous history of viral hepatitis. Steatosis (CAP \u2265\u2009248\u2009dB\/m) was present in 25.9% (95% confidence interval [CI] 23.3\u201328.9) of individuals, and among these, 87.7% met the MAFLD criteria. Only 22.9% of patients with steatosis had elevated alanine aminotransferase levels. Among participants with steatosis, prevalence of significant liver fibrosis (LSM \u2265\u20097.4\u00a0kPa) did not differ significantly according to whether they met MAFLD criteria (9.7% vs. 15.2%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u00a0=\u20090.276). In the multivariable model, odds of significant fibrosis did not differ significantly between these two groups. MAFLD criteria are met by most US adolescents with elastographic evidence of steatosis. Nonetheless, these criteria do not appear to improve detection of subjects with more advanced liver disease. Further longitudinal studies are needed to evaluate whether metabolic dysfunction is associated with faster progression toward inflammation, fibrosis, and liver\u2010related events.\n                  <\/jats:p>","DOI":"10.1002\/hep4.1969","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T05:45:28Z","timestamp":1650951928000},"page":"2070-2078","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":28,"title":["Impact of the new definition of metabolic dysfunction\u2013associated fatty liver disease on detection of significant liver fibrosis in US adolescents"],"prefix":"10.1097","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2422-3041","authenticated-orcid":false,"given":"Stefano","family":"Ciardullo","sequence":"first","affiliation":[{"name":"Department of Medicine and Rehabilitation,Policlinico di Monza,Monza,Italy"},{"name":"Department of Medicine and Surgery,University of Milano Bicocca,Milan,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Carbone","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Invernizzi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Center for Autoimmune Liver Diseases,Department of Medicine and Surgery,University of Milano\u2010Bicocca,Monza,Italy"},{"name":"European Reference Network on Hepatological Diseases (ERN RARE\u2010LIVER),San Gerardo Hospital,Monza,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3024-0457","authenticated-orcid":false,"given":"Gianluca","family":"Perseghin","sequence":"additional","affiliation":[{"name":"Department of Medicine and Rehabilitation,Policlinico di Monza,Monza,Italy"},{"name":"Department of Medicine and Surgery,University of Milano Bicocca,Milan,Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"key":"hep41969-bib-0001-20241129","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1055\/s-0038-1627456","article-title":"Nonalcoholic fatty liver disease in children","volume":"38","year":"2018","journal-title":"Semin Liver Dis"},{"key":"hep41969-bib-0002-20241129","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1007\/s40272-018-0292-2","article-title":"Nonalcoholic fatty liver disease in children: not a small matter","volume":"20","year":"2018","journal-title":"Paediatr Drugs"},{"key":"hep41969-bib-0003-20241129","doi-asserted-by":"crossref","first-page":"1814","DOI":"10.1053\/j.gastro.2007.08.077","article-title":"Prevalence of elevated alanine aminotransferase among US adolescents and associated factors: NHANES 1999\u20132004","volume":"133","year":"2007","journal-title":"Gastroenterology"},{"key":"hep41969-bib-0004-20241129","first-page":"727","article-title":"Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents","volume":"136","year":"2000","journal-title":"J Pediatr"},{"key":"hep41969-bib-0005-20241129","article-title":"The prevalence of non\u2010alcoholic fatty liver disease in children and adolescents: a systematic review and meta\u2010analysis","volume":"10","year":"2015","journal-title":"PLoS One"},{"key":"hep41969-bib-0006-20241129","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/hep.29367","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases","volume":"67","year":"2018","journal-title":"Hepatology"},{"key":"hep41969-bib-0007-20241129","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1097\/MPG.0000000000001482","article-title":"NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN)","volume":"64","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"hep41969-bib-0008-20241129","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1016\/j.jhep.2020.07.045","article-title":"A new definition for metabolic associated fatty liver disease: an international expert consensus statement","volume":"73","year":"2020","journal-title":"J 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adolescents ages 12\u201314 living in U.S. Households","volume":"78","year":"2017","journal-title":"J Stud Alcohol Drugs"},{"key":"hep41969-bib-0038-20241129","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1002\/hep.23425","article-title":"Pitfalls of liver stiffness measurement: a 5\u2010year prospective study of 13,369 examinations","volume":"51","year":"2010","journal-title":"Hepatology"}],"container-title":["Hepatology Communications"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hep4.1969","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hep4.1969","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1969","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T08:05:17Z","timestamp":1732867517000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1002\/hep4.1969"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,26]]},"references-count":34,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1002\/hep4.1969","relation":{},"ISSN":["2471-254X","2471-254X"],"issn-type":[{"value":"2471-254X","type":"print"},{"value":"2471-254X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,26]]},"assertion":[{"value":"2022-02-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}