Abstract：
OBJECTIVE: To 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.
METHODS: The 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.
RESULTS: Hepatologists 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.
CONCLUSIONS: Despite 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.
METHODS: The 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.
RESULTS: Hepatologists 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.
CONCLUSIONS: Despite 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.
摘要：
目的：评估中国医师对小儿非酒精性脂肪性肝病（NAFLD）的认识和知识，以及他们对NAFLD命名法从代谢功能障碍相关的脂肪肝（MAFLD）或代谢功能障碍相关的脂肪肝（MASLD）变化的态度。
方法：问卷调查包含五个部分（参与者的特征，流行病学,诊断,NAFLD的管理，以及对MAFLD/MASLD命名法的态度)。参与者包括53名肝病学家，88胃肠病学家（GEs），74内分泌学家（ENDOs），61名初级保健医生（PCP），和31个城市的157名儿科医生，中国大陆各省、自治区。
结果：肝病学家每年看到的儿童NAFLD患者数量最多（中位数9[范围1-20]），按PCP计算的人数最低(即使每年有一名患者)。儿科NAFLD知识的主要来源是通过指南获得的。在所有五种类型的医生中，肝病学家的总知识得分最高。大约三分之一的非专科医生（ENDOs和PCP）认为小儿NAFLD患者需要进行肝活检，在专家（肝病学家和GEs）中，这一百分比增加到一半。对于非专业人士，治疗小儿NAFLD的主要障碍是患者对改变生活方式的依从性差,以及对治疗NAFLD缺乏信心.90%以上的医师同意将NAFLD的命名改为MAFLD;然而,他们不确定这是否可以减轻经济负担。
结论：尽管小儿NAFLD在中国流行，在识别方面仍然存在很大的知识差距，诊断,和治疗小儿NAFLD，特别是在儿科医生和PCP等一线工人中。将来应该开展更多的教育计划。
方法：问卷调查包含五个部分（参与者的特征，流行病学,诊断,NAFLD的管理，以及对MAFLD/MASLD命名法的态度)。参与者包括53名肝病学家，88胃肠病学家（GEs），74内分泌学家（ENDOs），61名初级保健医生（PCP），和31个城市的157名儿科医生，中国大陆各省、自治区。
结果：肝病学家每年看到的儿童NAFLD患者数量最多（中位数9[范围1-20]），按PCP计算的人数最低(即使每年有一名患者)。儿科NAFLD知识的主要来源是通过指南获得的。在所有五种类型的医生中，肝病学家的总知识得分最高。大约三分之一的非专科医生（ENDOs和PCP）认为小儿NAFLD患者需要进行肝活检，在专家（肝病学家和GEs）中，这一百分比增加到一半。对于非专业人士，治疗小儿NAFLD的主要障碍是患者对改变生活方式的依从性差,以及对治疗NAFLD缺乏信心.90%以上的医师同意将NAFLD的命名改为MAFLD;然而,他们不确定这是否可以减轻经济负担。
结论：尽管小儿NAFLD在中国流行，在识别方面仍然存在很大的知识差距，诊断,和治疗小儿NAFLD，特别是在儿科医生和PCP等一线工人中。将来应该开展更多的教育计划。
