Журнал «Здоровье ребенка» Том 19, №2, 2024

Літературний огляд присвячений недостатньо вивченій у дитячій гастроентерології проблемі метаболічно асоційованої жирової хвороби печінки. До недавнього часу первинний стеатоз печінки, що не асоційований з прийомом алкоголю, визначався як неалкогольна жирова хвороба печінки. З огляду на єдність патогенетичних механізмів, які лежать в основі розвитку первинного стеатозу, пов’язаних з ним стеатогепатиту, фіброзу печінки з метаболічними порушеннями, як-от вісцеральне ожиріння, інсулінорезистентність, метазапалення жирової тканини, було запропоновано змінити термінологію. Авторами наведені дані стосовно сучасних номенклатурних дефініцій, етіологічних факторів, поширеності, критеріїв метаболічних порушень та метазапалення, асоційованих з цією нозологією та характерних саме для дитячого віку. Метаболічно асоційована жирова хвороба печінки та неалкогольна жирова хвороба печінки характеризуються розвитком гепато­стеатозу. Відмінною ознакою метаболічно асоційованої жирової хвороби є наявність метаболічних порушень у хворого. Вважають, що використання в клінічній практиці терміна «метаболічно асоційована жирова хвороба печінки» дозволяє лікарям вірогідніше встановлювати діагноз і точніше модифікувати спосіб життя хворого. Велика увага приділена опису гетерогенності метаболічно асоційованої жирової хвороби печінки в клінічній практиці та наведено стислий перелік терапевтичних можливостей щодо метаболічно асоційованої жирової хвороби печінки в дитячому віці.

The literature review deals with the problem of metabolic dysfunction-associated fatty liver disease that is poorly studied in pediatric gastroenterology. Until recently, primary hepatic steatosis not associated with alcohol intake was defined as non-alcoholic fatty liver disease. Given the unity of the pathogenetic mechanisms underlying primary steatosis, associated steatohepatitis, liver fibrosis with metabolic disorders, such as visceral obesity, insulin resistance, meta-inflammation of adipose tissue, it was proposed to change the terminology. The authors present data on modern nomenclature definitions, etiological factors, prevalence, criteria of metabolic disorders and meta-inflammation associated with this nosology and specific to childhood. Metabolic dysfunction-associated fatty liver disease and nonalcoholic fatty liver disease are characterized by the development of hepatosteatosis. However, a distinguishing feature of metabolic dysfunction-associated fatty liver disease is the presence of metabolic disorders in a patient. It is believed that the use of the term “metabolic dysfunction-associated fatty liver disease” in clinical practice allows doctors to make a diagnosis more reliably and more accurately modify the patient’s lifestyle. Much attention is paid to the description of the heterogeneity of metabolic dysfunction-associated fatty liver disease in clinical practice, and a concise list of therapeutic options for metabolic dysfunction-associated fatty liver disease in childhood is presented.

метаболічно асоційована жирова хвороба печінки; неалкогольна жирова хвороба печінки; метаболічно асоційована стеатотична хвороба печінки; ожиріння; діти; огляд

metabolic dysfunction-associated fatty liver disease; non-alcoholic fatty liver disease; metabolic dysfunction-associated steatotic liver disease; obesity; children; review

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