{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T18:51:13Z","timestamp":1784055073516,"version":"3.55.0"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To apply the new nomenclature for steatotic liver diseases (SLD), replacing nonalcoholic fatty liver disease (NAFLD) with metabolic dysfunction\u2010associated steatotic liver disease (MASLD), in adolescents using National Health and Nutrition Examination Survey (NHANES) data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Among 1410 adolescents (12\u201319 years) in NHANES (2017\u2010March, 2020), the controlled attenuation parameter (CAP) of transient elastography (TE) was used to define steatosis and fibrosis (TE\u2009\u2265\u20097.4\u2009kPa). Obesity and alanine aminotransferase (ALT)\u2009\u2265\u200980\u2009U\/L were used to identify adolescents qualifying for hepatology referral according to practice guidelines. NAFLD was defined as liver steatosis without a specific exposure; it has no cardiometabolic risk factor requirement, unlike MASLD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Steatosis (yes\/no) is the first decision point in the new diagnostic protocol; however, criteria for steatosis are undefined. At the supplier (EchoSens)\u2010recommended CAP threshold of 240\u2009dB\/m, 30.5% (95% confidence interval [CI]: 27.1%\u201334.0%) of adolescents had SLD and about 85% of adolescents with NAFLD met criteria for MASLD. The other 15% would receive an ambiguous diagnosis of either cryptogenic SLD or possible MASLD. At higher CAP thresholds, MASLD\/NAFLD concordance increased and approached 100%. Among adolescents with MASLD\u2010fibrosis, only 8.8% (95% CI: 0%\u201319.3%) had overweight\/obese and ALT\u2009\u2265\u200980\u2009U\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The new nomenclature highlights the high prevalence of liver steatosis. At the CAP threshold of 240\u2009dB\/m, however, approximately 15% of adolescents would receive an ambiguous diagnosis, which could lead to confusion and worry. Fewer than 10% of adolescents with MASLD\u2010fibrosis had overweight\/obese and ALT\u2009\u2265\u200980\u2009U\/L. Revised guidelines are needed to ensure that the other 90% receive appropriate referral and liver disease care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpn3.12230","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T06:48:35Z","timestamp":1714632515000},"page":"229-237","source":"Crossref","is-referenced-by-count":15,"title":["Fibrosis and steatotic liver disease in US adolescents according to the new nomenclature"],"prefix":"10.1002","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7630-3305","authenticated-orcid":false,"given":"Ning","family":"Ma","sequence":"first","affiliation":[{"name":"Division of Liver Diseases, Department of Medicine Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meena","family":"Bansal","sequence":"additional","affiliation":[{"name":"Division of Liver Diseases, Department of Medicine Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea D.","family":"Branch","sequence":"additional","affiliation":[{"name":"Division of Liver Diseases, Department of Medicine Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000412"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001482"},{"key":"e_1_2_8_5_1","first-page":"1","article-title":"National health and nutrition examination survey: analytic guidelines, 1999\u20102010","volume":"161","author":"Johnson CL","year":"2013","journal-title":"Vital Health Statis Ser 2 Data Eval Methods Res"},{"key":"e_1_2_8_6_1","unstructured":"National Health and Nutrition Examination Survey 2017\u2010March 2020 Data Documentation.https:\/\/wwwncdcgov\/Nchs\/Nhanes\/2017-2018\/P_LUXhtm"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.06.048"},{"key":"e_1_2_8_8_1","first-page":"1","article-title":"Prevalence of obesity and severe obesity among adults: United States, 2017\u20102018","volume":"360","author":"Hales CM","year":"2020","journal-title":"NCHS Data Brief"},{"key":"e_1_2_8_9_1","unstructured":"NHANES Response Rates and Population Totals.https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/responserates.aspx#population-totals"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-017-4638-3"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1760"}],"container-title":["Journal of Pediatric Gastroenterology and Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpn3.12230","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T03:42:44Z","timestamp":1722570164000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jpn3.12230"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/jpn3.12230"],"URL":"https:\/\/doi.org\/10.1002\/jpn3.12230","archive":["Portico"],"relation":{},"ISSN":["0277-2116","1536-4801"],"issn-type":[{"value":"0277-2116","type":"print"},{"value":"1536-4801","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]}}}