Published online Jun 27, 2022. doi: 10.4254/wjh.v14.i6.1235
Peer-review started: January 11, 2022
First decision: February 15, 2022
Revised: March 1, 2022
Accepted: May 27, 2022
Article in press: May 27, 2022
Published online: June 27, 2022
Processing time: 163 Days and 1.6 Hours
Prevalence of non-alcoholic fatty liver disease (NAFLD) in adolescents has more than doubled in the last two decades, with its downstream complications placing an increasing burden on healthcare systems globally.
At present, there is a paucity of treatment options NAFLD. In line with the developmental origins of heath and disease (DOHaD) concept, we hope to identify factors in early life where possible intervention can be instituted to prevent the development of NAFLD later in life.
To review the early developmental factors associated with NAFLD and potentially identify areas where intervention can be made to halt the progress to steatohepatitis, fibrosis and cirrhosis and/or hepatocellular carcinoma which may develop later in life.
Original research studies that included risk factors associated with early development of NAFLD in human subjects were identified from databases MEDLINE via PubMed, and EMBASE and relevant publications up to April 30, 2021 were assessed.
Genetic polymorphisms, familial factors such as maternal obesogenic environment and parental history of hepatic steatosis was associated with offspring NAFLD. Longer duration of exclusive breastfeeding in infancy was associated with a lower risk of developing NAFLD later in life while metabolic dysfunction and/or obesity in adolescence was associated with increased risk of NAFLD.
Our systematic review summarizes the current available literature on early developmental factors associated with hepatic steatosis. Maternal in utero environment, breastfeeding and nutritional, physical and genetic factors are associated with NAFLD.
Maternal metabolic dysfunction during pregnancy, being exclusively breastfed for a longer time postnatally, diet and physical activity in childhood and adolescence are potential areas where research and interventions can be explored to prevent the development of NAFLD. Studied in lean individuals with NAFLD are needed and would help to identify risk factors without the confounder of BMI.