Cargando…

Association Between Non-invasive Diagnostic Methods of Liver Fibrosis and Type 2 Diabetes in Pediatric Patients With Non-alcoholic Fatty Liver Disease

BACKGROUND AND PURPOSE: The prevalence of non-alcoholic fatty liver disease (NAFLD) in children has been increasing associated with insulin resistance. However, there is a scarcity of related studies in children with NAFLD with type 2 diabetes mellitus (T2DM) compared to adults. We conducted this st...

Descripción completa

Detalles Bibliográficos
Autores principales: Yang, Aram, Jung, Nayoung, Kim, Sinae, Lee, Ji-Eun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8866638/
https://www.ncbi.nlm.nih.gov/pubmed/35223701
http://dx.doi.org/10.3389/fped.2022.825141
_version_ 1784655874197815296
author Yang, Aram
Jung, Nayoung
Kim, Sinae
Lee, Ji-Eun
author_facet Yang, Aram
Jung, Nayoung
Kim, Sinae
Lee, Ji-Eun
author_sort Yang, Aram
collection PubMed
description BACKGROUND AND PURPOSE: The prevalence of non-alcoholic fatty liver disease (NAFLD) in children has been increasing associated with insulin resistance. However, there is a scarcity of related studies in children with NAFLD with type 2 diabetes mellitus (T2DM) compared to adults. We conducted this study to investigate the association between non-invasive diagnostic methods of liver fibrosis and T2DM in pediatric patients with NAFLD. METHODS: We enrolled a total of 152 patients aged <18 years with NAFLD, and compared their data according to the presence of T2DM. We evaluated fibrosis by transient elastography (TE, FibroScan®), and calculated the following fibrosis scores for each patient: NAFLD fibrosis score (NFS), AST: platelet ratio index (APRI), Fibrosis-4 (FIB-4) index, and pediatric NAFLD fibrosis index (PNFI). RESULTS: In the NAFLD–T2DM group, the NFS and mean controlled attenuation parameter in FibroScan were significantly higher than those in the nondiabetic group. The receiver operating characteristic (ROC) curve values for predicting the presence of T2DM were 0.78 for NFS, 0.64 for FIB-4, 0.62 for PNFI, and 0.61 for APRI. The cutoff HbA1c levels for predicting fibrosis progression in APRI, NFS, and PNFI were 5.7% [area under the curve (AUC) 0.74], 6.4% (AUC 0.71), and 6.4% (AUC 0.55), respectively. In the multivariate analysis, hepatosteatosis on abdomen sonography, NFS, FibroScan F, and APRI were independently associated with T2DM risk. CONCLUSIONS: We significantly characterized non-invasive fibrosis markers and elastography in pediatric NAFLD with T2DM compared with the nondiabetic group. We suggest evaluating the progression of fibrosis in the prediabetic stage in children using a combination of these non-invasive methods.
format Online
Article
Text
id pubmed-8866638
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-88666382022-02-25 Association Between Non-invasive Diagnostic Methods of Liver Fibrosis and Type 2 Diabetes in Pediatric Patients With Non-alcoholic Fatty Liver Disease Yang, Aram Jung, Nayoung Kim, Sinae Lee, Ji-Eun Front Pediatr Pediatrics BACKGROUND AND PURPOSE: The prevalence of non-alcoholic fatty liver disease (NAFLD) in children has been increasing associated with insulin resistance. However, there is a scarcity of related studies in children with NAFLD with type 2 diabetes mellitus (T2DM) compared to adults. We conducted this study to investigate the association between non-invasive diagnostic methods of liver fibrosis and T2DM in pediatric patients with NAFLD. METHODS: We enrolled a total of 152 patients aged <18 years with NAFLD, and compared their data according to the presence of T2DM. We evaluated fibrosis by transient elastography (TE, FibroScan®), and calculated the following fibrosis scores for each patient: NAFLD fibrosis score (NFS), AST: platelet ratio index (APRI), Fibrosis-4 (FIB-4) index, and pediatric NAFLD fibrosis index (PNFI). RESULTS: In the NAFLD–T2DM group, the NFS and mean controlled attenuation parameter in FibroScan were significantly higher than those in the nondiabetic group. The receiver operating characteristic (ROC) curve values for predicting the presence of T2DM were 0.78 for NFS, 0.64 for FIB-4, 0.62 for PNFI, and 0.61 for APRI. The cutoff HbA1c levels for predicting fibrosis progression in APRI, NFS, and PNFI were 5.7% [area under the curve (AUC) 0.74], 6.4% (AUC 0.71), and 6.4% (AUC 0.55), respectively. In the multivariate analysis, hepatosteatosis on abdomen sonography, NFS, FibroScan F, and APRI were independently associated with T2DM risk. CONCLUSIONS: We significantly characterized non-invasive fibrosis markers and elastography in pediatric NAFLD with T2DM compared with the nondiabetic group. We suggest evaluating the progression of fibrosis in the prediabetic stage in children using a combination of these non-invasive methods. Frontiers Media S.A. 2022-02-10 /pmc/articles/PMC8866638/ /pubmed/35223701 http://dx.doi.org/10.3389/fped.2022.825141 Text en Copyright © 2022 Yang, Jung, Kim and Lee. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Yang, Aram
Jung, Nayoung
Kim, Sinae
Lee, Ji-Eun
Association Between Non-invasive Diagnostic Methods of Liver Fibrosis and Type 2 Diabetes in Pediatric Patients With Non-alcoholic Fatty Liver Disease
title Association Between Non-invasive Diagnostic Methods of Liver Fibrosis and Type 2 Diabetes in Pediatric Patients With Non-alcoholic Fatty Liver Disease
title_full Association Between Non-invasive Diagnostic Methods of Liver Fibrosis and Type 2 Diabetes in Pediatric Patients With Non-alcoholic Fatty Liver Disease
title_fullStr Association Between Non-invasive Diagnostic Methods of Liver Fibrosis and Type 2 Diabetes in Pediatric Patients With Non-alcoholic Fatty Liver Disease
title_full_unstemmed Association Between Non-invasive Diagnostic Methods of Liver Fibrosis and Type 2 Diabetes in Pediatric Patients With Non-alcoholic Fatty Liver Disease
title_short Association Between Non-invasive Diagnostic Methods of Liver Fibrosis and Type 2 Diabetes in Pediatric Patients With Non-alcoholic Fatty Liver Disease
title_sort association between non-invasive diagnostic methods of liver fibrosis and type 2 diabetes in pediatric patients with non-alcoholic fatty liver disease
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8866638/
https://www.ncbi.nlm.nih.gov/pubmed/35223701
http://dx.doi.org/10.3389/fped.2022.825141
work_keys_str_mv AT yangaram associationbetweennoninvasivediagnosticmethodsofliverfibrosisandtype2diabetesinpediatricpatientswithnonalcoholicfattyliverdisease
AT jungnayoung associationbetweennoninvasivediagnosticmethodsofliverfibrosisandtype2diabetesinpediatricpatientswithnonalcoholicfattyliverdisease
AT kimsinae associationbetweennoninvasivediagnosticmethodsofliverfibrosisandtype2diabetesinpediatricpatientswithnonalcoholicfattyliverdisease
AT leejieun associationbetweennoninvasivediagnosticmethodsofliverfibrosisandtype2diabetesinpediatricpatientswithnonalcoholicfattyliverdisease