Reclassifying Pediatric NAFLD: Insights from the Steatotic Liver Disease Framework in a Multicenter NASH CRN Study

Highlight

• Majority (84%) of children clinically diagnosed with NAFLD meet criteria for metabolic dysfunction-associated steatotic liver disease (MASLD).
• Approximately 16% of pediatric patients are reclassified due to alcohol use below adult thresholds (Met-ALD) or drug-induced liver injury.
• Adolescents have a higher prevalence (5.4%) of Met-ALD, underscoring the importance of detailed alcohol consumption assessment in this group.
• A systematic diagnostic approach incorporating metabolic risk factors, alcohol exposure, and medication history is critical for accurate diagnosis and management of pediatric steatotic liver diseases.

Study Background