Affiliation:
1. Health Management Institute, The Second Medical Center & National Clinical Research Center for Geriatric Diseases Chinese PLA General Hospital Beijing China
2. Department of Maternal and Child Health, School of Public Health Peking University Beijing China
3. Department of Endocrinology and Metabolism Ningbo First Hospital Ningbo Zhejiang Province China
4. Department of Gastroenterology, Xinhua Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
5. Shanghai Key Lab of Pediatric Gastroenterology and Nutrition Shanghai China
Abstract
ObjectivesTo evaluate physicians’ awareness and knowledge towards pediatric nonalcoholic fatty liver disease (NAFLD) and their attitude toward change in nomenclature from NAFLD to metabolic dysfunction‐associated fatty liver disease (MAFLD) or metabolic dysfunction‐associated steatotic liver disease (MASLD) in China.MethodsThe questionnaire survey contained five parts (characteristics of the participants, epidemiology, diagnosis, management of NAFLD, and attitudes toward the nomenclature of MAFLD/MASLD). The participants included 53 hepatologists, 88 gastroenterologists (GEs), 74 endocrinologists (ENDOs), 61 primary care physicians (PCPs), and 157 pediatricians across 31 municipalities, provinces and autonomous regions of China's mainland.ResultsHepatologists saw the largest number of pediatric NAFLD patients annually (median 9 [range 1–20]), with the lowest number by PCPs (even notwithstanding one patient annually). The primary sources of pediatric NAFLD knowledge were acquired via guidelines. Hepatologists had the highest total knowledge score among all five types of physicians. Approximately one‐third of nonspecialists (ENDOs and PCPs) considered liver biopsy necessary for pediatric NAFLD patients, and this percentage increased to half in specialists (hepatologists and GEs). For nonspecialists, the major barriers to the management of pediatric NAFLD were poor patient adherence to lifestyle modifications and lacking confidence in managing NAFLD. Above 90% physicians agreed to change the nomenclature NAFLD to MAFLD; however, they were not sure whether it could reduce the economic burden.ConclusionsDespite the epidemic of pediatric NAFLD in China, a significant knowledge gap remains in the identification, diagnosis, and treatment of pediatric NAFLD, particularly among frontline workers such as pediatricians and PCPs. More education programs should be carried out in the future.