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Non-alcoholic fatty liver disease (NAFLD) is a multifactorial condition that encompasses a wide spectrum of liver abnormalities ranging from simple liver steatosis to steatohepatitis (non-alcoholic steatohepatitis), which may be associated with fibrosis and progress to cirrhosis and end-stage liver disease. NAFLD has recently become the most common cause of chronic liver disease in children and adolescents. NAFLD prevalence, alongside obesity, continues to increase among pediatric patients. Obesity is believed to represent a major risk factor for NAFLD, which is considered to be the liver presentation of the metabolic syndrome. Although the pathogenesis of NAFLD is not fully understood, the notion that multiple factors affect disease development and progression is widely accepted. Both genetic background and environmental factors contribute to NAFLD development. A more complete understanding of the pathogenesis may aid in developing non-invasive diagnostic tools and identifying new therapeutic targets. Liver biopsy currently remains the gold standard for NAFLD diagnosis and staging. Although lifestyle and diet modifications are key in NAFLD treatment, the development of new pharmacological therapies is crucial for patients who are unresponsive to first-line therapy. Conclusion: Pediatric NAFLD is an increasing public health issue that remains underdiagnosed. A large-scale screening in the high-risk population, especially among the overweight pediatric patients, should be considered, including measurement of serum transaminases and liver ultrasound. It is crucial to treat this condition as soon as possible in order to avoid the progression to end-stage liver disease. [ABSTRACT FROM AUTHOR]

Background In CF children, LCI is a more sensitive index of lung disease than FEV1. However, some studies included significant proportions of children with abnormal FEV1 and data obtained using commercially available devices are still limited. Objective To compare diagnostic performance of LCI measurements using two commercially available devices in a clinic where median FEV1 of children (6—<18) exceeds the predicted value (Wang & Hankinson) since 2006. Methods Children were studied under stable condition, in the setting of a routine visit. Before spirometry, MBWN2 was performed in duplicate using both the Exhalyzer D (Ecomedics, Switzerland) and the EasyOne Pro (NDD, Switzerland), in random order on the same session. Agreement between devices was assessed by Bland–Altman plot. Diagnostic performance of LCI was defined as the proportion of patients with LCI z-score >2 (reference values derived from duplicate measurements in 47 healthy children). Results 2 acceptable LCI values were obtained with both devices in 44 children with CF [25 M, mean (SD) age: 12.9 y (3.7), range: 6–18]. All had normal FEV1: mean (SD) 100% (14.1) according to GLI. Mean LCI was 9.81 (2.23) with EM and 8.35 (1.86) with NDD, corresponding to +5 and +2.5 SD respectively; mean difference (95% confidence interval) was 1.46 (–1.75, 4.67). The proportion of patients with normal FEV1 but high LCI was 32/44 (73%) with EM and 18/44 (41%) with NDD, p = 0.001. Diagnostic performances of FEF 25–75 and LCI NDD were comparable. Conclusion In this group of CF children with normal FEV1, EM yielded higher LCI values and was significantly more sensitive than NDD in detecting ventilation abnormalities. [ABSTRACT FROM AUTHOR]