{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:56:17Z","timestamp":1792090577142,"version":"4.4.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Metabolic\u00a0dysfunction-associated steatotic liver disease (MASLD) has increased rapidly. NASPGHAN recommends screening children at risk for MASLD, but its implementation remains unclear. We explored the implementation of screening in healthcare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from 908 children (median 11.4 years, 42.7% girls) investigated for overweight\/obesity. Emphasis was placed on screening methods, diagnosis and potential secular changes. The diagnosis was confirmed retrospectively using novel criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Investigations included measuring alanine aminotransferase (ALT) in 83.1%, ultrasonography in 9.1%, and no screening in 16.5%. Screening was conducted in 86.2% of children meeting the recommendations, but 69.3% of those not eligible, mostly due to young age, were also screened. Screening was more frequent in tertiary care. Overall, 87.9% were tested for metabolic comorbidities and 80.9% underwent differential diagnostics, with 5.7% having other liver-affecting diseases\/medications. ALT testing increased in tertiary care from 81.9% in 2002-2011 to 91.4% in 2012-2020 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and exclusion of liver-affecting conditions improved in both tertiary (79.6%\u00a0vs. 87.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017) and primary care (61.5% vs. 84.6%, p\u2009&lt;\u20090.001). MASLD was diagnosed clinically in 7.4%, while 14.5% met the criteria retrospectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MASLD screening practices are mostly aligned with the recommendations. However, many patients remain unrecognized, underscoring the need for better guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>In a large cohort of 3-17-year-old children investigated in healthcare due to obesity, implementation of MASLD screening largely aligned with current recommendations supporting general acceptance of screening.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Screening was conducted in 86.2% of children meeting the NASPGHAN screening recommendations, while 87.9% were also tested for metabolic comorbidities, and 80.9% underwent differential diagnostics.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>MASLD was diagnosed clinically in 7.4%, while 14.5% met the criteria retrospectively, suggesting possible underdiagnosis.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Compared to NASPGHAN guidelines, screening appeared excessive among younger children. Nevertheless, MASLD was also prevalent in this age group, indicating a need for further research to determine optimal age thresholds.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-025-04540-w","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T18:33:40Z","timestamp":1761849220000},"page":"263-269","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Screening and diagnosis of metabolic dysfunction-associated steatotic liver disease in children within public healthcare"],"prefix":"10.1038","volume":"100","author":[{"given":"Lyydia","family":"Lahtinen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauliina","family":"Hiltunen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Vuorela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heini","family":"Huhtala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalle","family":"Kurppa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4627-7892","authenticated-orcid":false,"given":"Linnea","family":"Aitokari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"4540_CR1","first-page":"1","volume":"9","author":"NB Lister","year":"2023","unstructured":"Lister, N. 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