Pediatric MASLD in China: epidemiology, screening, diagnosis, and management

Xiaoguo Li; Xiao-Dong Zhou; Jie Wu; Zhenhua Zhao; Feng Xie; Yiling Li; Wenhui Li; Xiaosong Yan; Sumin Sui; Liting Zhang; Ming-Hua Zheng; Yuemin Nan; Xiaolong Qi

doi:10.1016/j.lanwpc.2025.101717

Pediatric MASLD in China: epidemiology, screening, diagnosis, and management

Lancet Reg Health West Pac. 2025 Oct 18:64:101717. doi: 10.1016/j.lanwpc.2025.101717. eCollection 2025 Nov.

Authors

Xiaoguo Li^{1

2

3}, Xiao-Dong Zhou⁴, Jie Wu⁵, Zhenhua Zhao⁶, Feng Xie⁷, Yiling Li⁸, Wenhui Li⁹, Xiaosong Yan¹⁰, Sumin Sui¹¹, Liting Zhang³, Ming-Hua Zheng⁴, Yuemin Nan¹², Xiaolong Qi^{1

2}

Affiliations

¹ Liver Disease Center of Integrated Traditional Chinese and Western Medicine, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology (Southeast University), Nanjing, China.
² Basic Medicine Research and Innovation Center of Ministry of Education, Zhongda Hospital, Southeast University; State Key Laboratory of Digital Medical Engineering, Nanjing, China.
³ Department of Hepatology, First Hospital of Lanzhou University, Lanzhou, China.
⁴ MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
⁵ Department of Gastroenterology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
⁶ Department of Radiology, Shaoxing People's Hospital (Shaoxing Hospital of Zhejiang University), Shaoxing, China.
⁷ Functional Inspection Center, Lanzhou Maternal and Child Health Care Hospital, Lanzhou, China.
⁸ Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China.
⁹ Department of Hospital Administration, Yancheng Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Yancheng, China.
¹⁰ Department of Surgery, Third People's Hospital of Tibet, Lhasa, China.
¹¹ Department of Pediatric, The People's Hospital of Bozhou, Bozhou, China.
¹² Department of Traditional and Western Medical Hepatology, Hebei Medical University Third Hospital, Shijiazhuang, China.

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging global epidemic, with a rapidly increasing burden among children and adolescents in China. This alarming trend is primarily driven by profound lifestyle shifts. Unlike earlier perceptions of pediatric MASLD as relatively benign, pediatric-onset MASLD is now recognized as a progressive condition associated with liver fibrosis, cirrhosis, cardiometabolic comorbidities, and elevated risks of hepatocellular carcinoma and early mortality. In China, this escalating burden is compounded by regional disparities, diagnostic challenges, and limited access to pediatric-specific screening and management tools. Yet early-life detection and intervention present a critical window to mitigate long-term liver-related and systemic health consequences. This review synthesizes the latest epidemiological data, screening strategies, diagnostic innovations, and therapeutic approaches for pediatric MASLD in the Chinese context. By integrating emerging evidence with national public health priorities, we aim to inform actionable policies and tailored intervention strategies to confront this growing epidemic.

Keywords: Childhood obesity; Epidemiology in China; Lifestyle intervention; Non-invasive screening; Pediatric metabolic dysfunction-associated steatotic liver disease; liver steatosis.

Publication types

Review