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Time to consider a holistic approach to the treatment of non-alcoholic fatty liver disease in obese young people?
  1. Christopher D Byrne1,
  2. Giovanni Targher2
  1. 1 Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
  2. 2 Department of Endocrinology and Metabolism, University of Verona Department of Medicine, Verona, Italy
  1. Correspondence to Professor Christopher D Byrne, Southampton General Hospital, Southampton SO16 6YD, UK; c.d.byrne{at}

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During the last decade, evidence has accumulated to show that nonalcoholic fatty liver disease (NAFLD) is a ‘multisystem’ disease often associated with obesity and other cardiometabolic disorders.1 NAFLD increases risk of liver-related complications and increases risk of developing type 2 diabetes (T2D),2 cardiovascular disease (CVD),3 chronic kidney disease4 and certain extrahepatic cancers.5 Thus, there is now important evidence to support a holistic approach to the treatment of NAFLD in adulthood and that approach extends to risk management of other diseases beyond the liver.

With the burgeoning 21st century problem of obesity in childhood, it is now apparent that NAFLD is also a common disease in young people with overweight or obesity.6 Bearing in mind the evidence in adults that NAFLD increases risk of extrahepatic diseases, this also raises the possibility that NAFLD in childhood may not be harmless and that NAFLD may also have important implications for the health of young people as they grow older.7

Simon et al 8 have previously reported important data from a nationwide cohort of Swedish adults with histologically confirmed NAFLD and without pre-existing CVD at baseline (n=10 422). In that retrospective cohort study, the authors showed that over a median of 13.6 years of follow-up, NAFLD was associated with a ~65% increased …

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  • Contributors Both authors contributed equally.

  • Funding CDB is supported in part by the Southampton National Institute for Health and Care Excellence Biomedical Research Centre (IS-BRC-20004), UK. GT is supported in part by grants from the University School of Medicine of Verona, Verona, Italy.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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