{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T08:28:31Z","timestamp":1793521711935,"version":"4.5.0"},"reference-count":218,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000288","name":"Royal Society","doi-asserted-by":"publisher","award":["RG\\R1\\241312"],"award-info":[{"award-number":["RG\\R1\\241312"]}],"id":[{"id":"10.13039\/501100000288","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000350","name":"Guts UK Charity","doi-asserted-by":"publisher","award":["BSPGHAN2023_01"],"award-info":[{"award-number":["BSPGHAN2023_01"]}],"id":[{"id":"10.13039\/501100000350","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000395","name":"Royal College of Physicians","doi-asserted-by":"publisher","award":["Dame Sheila Sherlock Bursary"],"award-info":[{"award-number":["Dame Sheila Sherlock Bursary"]}],"id":[{"id":"10.13039\/501100000395","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Metabolic dysfunction\u2010associated steatotic liver disease (MASLD) is the most common reason for elevated liver enzymes in children in Europe, affecting more than 5% of all children. Since the last iteration of this position paper, there have been substantial advances in our understanding of the disease. After a detailed literature review and thorough discussion, we established consensus recommendations for the diagnosis and assessment of MASLD in children. Alanine aminotransferase (ALT)\u2009\u2265\u200930 IU\/L is a suitable screening test for MASLD in children over 10 years of age with obesity (body mass index\n                    <jats:italic>z<\/jats:italic>\n                    \u2010score \u2265+2), or in children of any age with additional risk factors. All patients with suspected MASLD should be assessed for alternative or concomitant diagnoses, as well as comorbidities. Patients who are not overweight, under 8 years old, or have any other red flags should be promptly referred for specialist assessment. Liver biopsy remains the gold standard for diagnosis and staging of MASLD, but should be reserved for diagnostic uncertainty, to guide treatment decisions, and risk stratification (e.g., prior to transition to adult care). While there is emerging data for non\u2010invasive tests (e.g., transient elastography), it is unclear how to routinely implement these investigations in clinical practice. Combined changes of \u226520% in both ALT and gamma\u2010glutamyl transferase may represent a useful non\u2010invasive tool for monitoring disease severity over time. Most patients are appropriately investigated and managed by non\u2010specialists where the focus is on holistic management of obesity and its complications. Future research should focus on how to use non\u2010invasive tests to risk\u2010stratify children, in particular, how to identify those with advanced fibrosis.\n                  <\/jats:p>","DOI":"10.1002\/jpn3.70490","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T07:51:13Z","timestamp":1782805873000},"page":"555-576","source":"Crossref","is-referenced-by-count":9,"title":["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\u2010associated steatotic liver disease"],"prefix":"10.1002","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4711-9215","authenticated-orcid":false,"given":"Jake P.","family":"Mann","sequence":"first","affiliation":[{"name":"Department of Immunology &amp; Immunotherapy, School of Infection, Inflammation and Immunology, College of Medicine 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