{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:13:31Z","timestamp":1782846811196,"version":"3.54.5"},"reference-count":32,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":167,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"publisher","award":["2023YFC2308104"],"award-info":[{"award-number":["2023YFC2308104"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"publisher","award":["2023YFC2308100"],"award-info":[{"award-number":["2023YFC2308100"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009331","name":"Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support","doi-asserted-by":"publisher","award":["ZLRK202301"],"award-info":[{"award-number":["ZLRK202301"]}],"id":[{"id":"10.13039\/501100009331","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["92159305"],"award-info":[{"award-number":["92159305"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Metabolic dysfunction-associated steatotic liver disease (MASLD) has been proposed to replace the term of non-alcoholic fatty liver disease (NAFLD). To investigate the effect of MASLD on liver fibrosis and validate the clinical utility of MASLD criteria, differences in disease severity and clinical outcomes between MASLD and NAFLD were compared in a biopsy-proven pediatric cohort. The retrospective clinical data of 427 children with biopsy-proven steatotic liver between 2010 and 2021 were consecutively collected and categorized into three distinct subgroups of MASLD-only, NAFLD-only, and MASLD\u2013NAFLD according to the diagnostic guidelines. Patients with MASLD-only and MASLD\u2013NAFLD had more features of metabolic disorders, with higher level of triglycerides but lower level of high-density lipoprotein cholesterol than NAFLD-only. The proportion of significant fibrosis was highest in MASLD-only patients (68.0%), followed by those with MASLD\u2013NAFLD and NAFLD-only (43.3% and 19.4%, respectively; P\u2009&amp;lt;\u20090.001). More steatohepatitis was presented in MASLD\u2013NAFLD group than the other two groups (66.1% vs 30.8% vs 22.6%, P\u2009&amp;lt;\u20090.001). Multivariate regression revealed that children with MASLD-only had 5.8-fold greater risk of significant fibrosis than those with NAFLD-only (P\u2009=\u20090.001). After a median follow-up of 83\u2009months, 14 of 427 patients developed clinical outcomes. Kaplan\u2013Meier curves indicated no difference in the cumulative incidence of clinical events between the groups (log-rank, P\u2009=\u20090.073). Children in MASLD group tended to have concomitant with severe liver fibrosis and related metabolic diseases compared to those with NAFLD-only in pediatric cohort. Thus, the redefinition of MASLD may improve the detection of children with severe disease that need early intervention.<\/jats:p>","DOI":"10.1093\/gastro\/goaf056","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T14:12:26Z","timestamp":1750947146000},"source":"Crossref","is-referenced-by-count":5,"title":["Metabolic dysfunction-associated steatotic liver disease is associated with the risk of severe liver fibrosis in pediatric population"],"prefix":"10.1093","volume":"13","author":[{"given":"Wei","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pathology and Hepatology, The Fifth Medical Center of Chinese PLA General Hospital , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Hepatology, The Fifth Medical Center of Chinese PLA General Hospital , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology and Hepatology, The Fifth Medical Center of Chinese PLA General Hospital , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"Medical School of Chinese PLA , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pathology and Hepatology, The Fifth Medical Center of Chinese PLA General Hospital , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bokang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Hepatology, The First Hospital of Jilin University , Changchun, Jilin, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yisi","family":"Liu","sequence":"additional","affiliation":[{"name":"First Department of Liver Disease Center, Capital Medical University , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology and Hepatology, The Fifth Medical Center of Chinese PLA General Hospital , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyun","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Hepatology, The Fifth Medical Center of Chinese PLA General Hospital , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology and Hepatology, The Fifth Medical Center of Chinese PLA General Hospital , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8933-6392","authenticated-orcid":false,"given":"Ping","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Interventional Ultrasound, The Fifth Medical Center of Chinese PLA General Hospital , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junqi","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Hepatology, The First Hospital of Jilin University , Changchun, Jilin, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingmin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pathology and Hepatology, The Fifth Medical Center of Chinese PLA General Hospital , Beijing, P. R.","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"2025081215094320900_goaf056-B1","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.3350\/cmh.2024.0431","article-title":"Epidemiology of metabolic dysfunction-associated steatotic liver disease","volume":"31","author":"Younossi","year":"2025","journal-title":"Clin Mol Hepatol"},{"key":"2025081215094320900_goaf056-B2","doi-asserted-by":"crossref","first-page":"9924","DOI":"10.3390\/ijms25189924","article-title":"Converging pathways between metabolic dysfunction-associated steatotic liver disease (MASLD) and diabetes in children","volume":"25","author":"Maria","year":"2024","journal-title":"Int J Mol Sci"},{"key":"2025081215094320900_goaf056-B3","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1002\/hep.32228","article-title":"Global burden of NAFLD and chronic liver disease among adolescents and young adults","volume":"75","author":"Paik","year":"2022","journal-title":"Hepatology"},{"key":"2025081215094320900_goaf056-B4","doi-asserted-by":"crossref","first-page":"1433857","DOI":"10.3389\/fcell.2024.1433857","article-title":"Systemic impacts of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) on heart, muscle, and kidney related diseases","volume":"12","author":"Reddemma","year":"2024","journal-title":"Front Cell Dev Biol"},{"key":"2025081215094320900_goaf056-B5","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1016\/j.cmet.2023.10.009","article-title":"The bidirectional immune crosstalk in metabolic dysfunction-associated steatotic liver disease","volume":"35","author":"Keisuke","year":"2023","journal-title":"Cell Metab"},{"key":"2025081215094320900_goaf056-B6","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1016\/j.jhep.2023.10.021","article-title":"MASLD vs. NAFLD: a better definition for children with obesity at higher risk of kidney damage","volume":"80","author":"Anna","year":"2024","journal-title":"J Hepatol"},{"key":"2025081215094320900_goaf056-B7","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1007\/s12020-024-03783-7","article-title":"Diet, exercise, and supplements: what is their role in the management of the metabolic dysfunction-associated steatotic liver disease in children?","volume":"85","author":"Anastasios","year":"2024","journal-title":"Endocrine"},{"key":"2025081215094320900_goaf056-B8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s00431-024-05848-1","article-title":"Pediatric MASLD: current understanding and practical approach","volume":"184","author":"Anne-Sophie","year":"2024","journal-title":"Eur J Pediatr"},{"key":"2025081215094320900_goaf056-B9","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1136\/gut.2008.171280","article-title":"The natural history of nonalcoholic fatty liver disease in children: a follow-up study for up to 20 years","volume":"58","author":"Feldstein","year":"2009","journal-title":"Gut"},{"key":"2025081215094320900_goaf056-B10","doi-asserted-by":"crossref","first-page":"e99\u2013102","DOI":"10.1111\/j.2047-6310.2013.00209.x","article-title":"Non-alcoholic fatty liver disease and hepatocellular carcinoma in a 7-year-old obese boy: coincidence or comorbidity?","volume":"9","author":"Nobili","year":"2014","journal-title":"Pediatr Obes"},{"key":"2025081215094320900_goaf056-B11","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1097\/HEP.0000000000000520","article-title":"A multisociety Delphi consensus statement on new fatty liver disease nomenclature","volume":"78","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"2025081215094320900_goaf056-B12","doi-asserted-by":"crossref","first-page":"e154","DOI":"10.1016\/j.jhep.2023.09.033","article-title":"Transitioning from NAFLD to MAFLD and MASLD: consistent prevalence and risk factors in a Chinese cohort","volume":"80","author":"Yang","year":"2024","journal-title":"J Hepatol"},{"key":"2025081215094320900_goaf056-B13","doi-asserted-by":"crossref","first-page":"e64","DOI":"10.1016\/j.jhep.2023.08.021","article-title":"Clinical and histological features under different nomenclatures of fatty liver disease: NAFLD, MAFLD, MASLD and MetALD","volume":"80","author":"Chen","year":"2024","journal-title":"J Hepatol"},{"key":"2025081215094320900_goaf056-B14","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/liv.15856","article-title":"Comparison of NAFLD, MAFLD and MASLD characteristics and mortality outcomes in United States adults","volume":"44","author":"Song","year":"2024","journal-title":"Liver Int"},{"key":"2025081215094320900_goaf056-B15","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 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Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN)","volume":"64","author":"Vos","year":"2017","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2025081215094320900_goaf056-B22","doi-asserted-by":"crossref","first-page":"e2022060640","DOI":"10.1542\/peds.2022-060640","article-title":"Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity","volume":"151","author":"Hampl","year":"2023","journal-title":"Pediatrics"},{"key":"2025081215094320900_goaf056-B23","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.2337\/dc20-S002","article-title":"2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2020","volume":"43","author":"American Diabetes Association","year":"2020","journal-title":"Diabetes Care"},{"key":"2025081215094320900_goaf056-B24","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/MOG.0000000000000823","article-title":"Metabolic dysfunction-associated fatty liver disease: a year in review","volume":"38","author":"Alharthi","year":"2022","journal-title":"Curr Opin Gastroenterol"},{"key":"2025081215094320900_goaf056-B25","doi-asserted-by":"crossref","first-page":"451","DOI":"10.5009\/gnl20218","article-title":"Clinical and histologic features of patients with biopsy-proven metabolic dysfunction-associated fatty liver disease","volume":"15","author":"Huang","year":"2021","journal-title":"Gut Liver"},{"key":"2025081215094320900_goaf056-B26","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1002\/hep.32131","article-title":"Metabolic dysfunction-associated fatty liver disease improves detection of high liver stiffness: The Rotterdam Study","volume":"75","author":"van Kleef","year":"2022","journal-title":"Hepatology"},{"key":"2025081215094320900_goaf056-B27","doi-asserted-by":"crossref","first-page":"e76","DOI":"10.1016\/j.jhep.2023.08.026","article-title":"99% of patients with NAFLD meet MASLD criteria and natural history is therefore identical","volume":"80","author":"Hagstr\u00f6m","year":"2024","journal-title":"J Hepatol"},{"key":"2025081215094320900_goaf056-B28","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/j.tem.2021.04.008","article-title":"Links between metabolic syndrome and metabolic dysfunction-associated fatty liver disease","volume":"32","author":"Lim","year":"2021","journal-title":"Trends Endocrinol Metab"},{"key":"2025081215094320900_goaf056-B29","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1111\/liv.14369","article-title":"Chronic hepatitis B and non-alcoholic fatty liver disease: conspirators or competitors?","volume":"40","author":"Zhang","year":"2020","journal-title":"Liver Int"},{"key":"2025081215094320900_goaf056-B30","doi-asserted-by":"crossref","first-page":"2180","DOI":"10.1002\/hep.26072","article-title":"Hepatic fat loss in advanced nonalcoholic steatohepatitis: are alterations in serum adiponectin the cause?","volume":"57","author":"VAN","year":"2013","journal-title":"Hepatology"},{"key":"2025081215094320900_goaf056-B31","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1111\/apt.18011","article-title":"Steatotic liver disease-associated all-cause\/cause-specific mortality in the United States","volume":"60","author":"Kim","year":"2024","journal-title":"Aliment Pharmacol Ther"},{"key":"2025081215094320900_goaf056-B32","doi-asserted-by":"crossref","first-page":"5462","DOI":"10.3390\/ijms22115462","article-title":"Non-obese MAFLD is associated with colorectal adenoma in health check examinees: a multicenter retrospective study","volume":"22","author":"Fukunaga","year":"2021","journal-title":"Int J Mol Sci"}],"container-title":["Gastroenterology Report"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/gastro\/article-pdf\/doi\/10.1093\/gastro\/goaf056\/63503058\/goaf056.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/gastro\/article-pdf\/doi\/10.1093\/gastro\/goaf056\/63503058\/goaf056.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T19:09:51Z","timestamp":1755025791000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/gastro\/article\/doi\/10.1093\/gastro\/goaf056\/8164294"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":32,"URL":"https:\/\/doi.org\/10.1093\/gastro\/goaf056","relation":{},"ISSN":["2052-0034"],"issn-type":[{"value":"2052-0034","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025]]},"published":{"date-parts":[[2025]]},"article-number":"goaf056"}}