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Usefulness of Transient Elastography for Non-Invasive Diagnosis of Liver Fibrosis in Pediatric Non-Alcoholic Steatohepatitis

BACKGROUND: Transient elastography (FibroScan(®)) is a non-invasive and rapid method for assessing liver fibrosis. While the feasibility and usefulness of FibroScan(®) have been proven in adults, few studies have focused on pediatric populations. We aimed to determine the feasibility and usefulness...

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Autores principales: Kwon, Young Dai, Ko, Kyung Ok, Lim, Jae Woo, Cheon, Eun Jung, Song, Young Hwa, Yoon, Jung Min
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565925/
https://www.ncbi.nlm.nih.gov/pubmed/31197983
http://dx.doi.org/10.3346/jkms.2019.34.e165
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author Kwon, Young Dai
Ko, Kyung Ok
Lim, Jae Woo
Cheon, Eun Jung
Song, Young Hwa
Yoon, Jung Min
author_facet Kwon, Young Dai
Ko, Kyung Ok
Lim, Jae Woo
Cheon, Eun Jung
Song, Young Hwa
Yoon, Jung Min
author_sort Kwon, Young Dai
collection PubMed
description BACKGROUND: Transient elastography (FibroScan(®)) is a non-invasive and rapid method for assessing liver fibrosis. While the feasibility and usefulness of FibroScan(®) have been proven in adults, few studies have focused on pediatric populations. We aimed to determine the feasibility and usefulness of FibroScan(®) in Korean children. METHODS: FibroScan(®) examinations were performed in 106 children (age, 5–15 years) who visited the Konyang University Hospital between June and September 2018. Liver steatosis was measured in terms of the controlled attenuation parameter (CAP), while hepatic fibrosis was evaluated in terms of the liver stiffness measurement (LSM). Children were stratified into obese and non-obese controls, according to body mass index (≥ or < 95th percentile, respectively). RESULTS: The obese group was characterized by significantly higher levels of aspartate aminotransferase (AST, 57.00 ± 48.47 vs. 26.40 ± 11.80 IU/L; P < 0.001) and alanine aminotransferase (ALT, 91.27 ± 97.67 vs. 16.28 ± 9.78 IU/L; P < 0.001), frequency of hypertension and abdominal obesity (abdominal circumference > 95% percentile) (P < 0.001), CAP (244.4–340.98 dB/m), and LSM (3.85–7.77 kPa) (P < 0.001). On FibroScan(®), 30 of 59 obese children had fibrosis (LSM > 5.5 kPa), whereas the remaining 29 did not (LSM < 5.5 kPa). Obese children with fibrosis had higher levels of AST (73.57 ± 56.00 vs. 39.86 ± 31.93 IU/L; P = 0.009), ALT (132.47 ± 113.88 vs. 48.66 ± 51.29 IU/L; P = 0.001), and gamma-glutamyl transferase (106.67 ± 69.31 vs. 28.80 ± 24.26 IU/L; P = 0.042) compared to obese children without fibrosis. LSM had high and significant correlation (P < 0.05) with AST, ALT, homeostasis model assessment for insulin resistance, and AST-to-platelet ratio index. CONCLUSION: FibroScan(®) is clinically feasible and facilitates non-invasive, rapid, reproducible, and reliable detection of hepatic steatosis and liver fibrosis in the Korean pediatric population.
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spelling pubmed-65659252019-06-21 Usefulness of Transient Elastography for Non-Invasive Diagnosis of Liver Fibrosis in Pediatric Non-Alcoholic Steatohepatitis Kwon, Young Dai Ko, Kyung Ok Lim, Jae Woo Cheon, Eun Jung Song, Young Hwa Yoon, Jung Min J Korean Med Sci Original Article BACKGROUND: Transient elastography (FibroScan(®)) is a non-invasive and rapid method for assessing liver fibrosis. While the feasibility and usefulness of FibroScan(®) have been proven in adults, few studies have focused on pediatric populations. We aimed to determine the feasibility and usefulness of FibroScan(®) in Korean children. METHODS: FibroScan(®) examinations were performed in 106 children (age, 5–15 years) who visited the Konyang University Hospital between June and September 2018. Liver steatosis was measured in terms of the controlled attenuation parameter (CAP), while hepatic fibrosis was evaluated in terms of the liver stiffness measurement (LSM). Children were stratified into obese and non-obese controls, according to body mass index (≥ or < 95th percentile, respectively). RESULTS: The obese group was characterized by significantly higher levels of aspartate aminotransferase (AST, 57.00 ± 48.47 vs. 26.40 ± 11.80 IU/L; P < 0.001) and alanine aminotransferase (ALT, 91.27 ± 97.67 vs. 16.28 ± 9.78 IU/L; P < 0.001), frequency of hypertension and abdominal obesity (abdominal circumference > 95% percentile) (P < 0.001), CAP (244.4–340.98 dB/m), and LSM (3.85–7.77 kPa) (P < 0.001). On FibroScan(®), 30 of 59 obese children had fibrosis (LSM > 5.5 kPa), whereas the remaining 29 did not (LSM < 5.5 kPa). Obese children with fibrosis had higher levels of AST (73.57 ± 56.00 vs. 39.86 ± 31.93 IU/L; P = 0.009), ALT (132.47 ± 113.88 vs. 48.66 ± 51.29 IU/L; P = 0.001), and gamma-glutamyl transferase (106.67 ± 69.31 vs. 28.80 ± 24.26 IU/L; P = 0.042) compared to obese children without fibrosis. LSM had high and significant correlation (P < 0.05) with AST, ALT, homeostasis model assessment for insulin resistance, and AST-to-platelet ratio index. CONCLUSION: FibroScan(®) is clinically feasible and facilitates non-invasive, rapid, reproducible, and reliable detection of hepatic steatosis and liver fibrosis in the Korean pediatric population. The Korean Academy of Medical Sciences 2019-06-04 /pmc/articles/PMC6565925/ /pubmed/31197983 http://dx.doi.org/10.3346/jkms.2019.34.e165 Text en © 2019 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kwon, Young Dai
Ko, Kyung Ok
Lim, Jae Woo
Cheon, Eun Jung
Song, Young Hwa
Yoon, Jung Min
Usefulness of Transient Elastography for Non-Invasive Diagnosis of Liver Fibrosis in Pediatric Non-Alcoholic Steatohepatitis
title Usefulness of Transient Elastography for Non-Invasive Diagnosis of Liver Fibrosis in Pediatric Non-Alcoholic Steatohepatitis
title_full Usefulness of Transient Elastography for Non-Invasive Diagnosis of Liver Fibrosis in Pediatric Non-Alcoholic Steatohepatitis
title_fullStr Usefulness of Transient Elastography for Non-Invasive Diagnosis of Liver Fibrosis in Pediatric Non-Alcoholic Steatohepatitis
title_full_unstemmed Usefulness of Transient Elastography for Non-Invasive Diagnosis of Liver Fibrosis in Pediatric Non-Alcoholic Steatohepatitis
title_short Usefulness of Transient Elastography for Non-Invasive Diagnosis of Liver Fibrosis in Pediatric Non-Alcoholic Steatohepatitis
title_sort usefulness of transient elastography for non-invasive diagnosis of liver fibrosis in pediatric non-alcoholic steatohepatitis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565925/
https://www.ncbi.nlm.nih.gov/pubmed/31197983
http://dx.doi.org/10.3346/jkms.2019.34.e165
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