Journal article
A clinical model to predict fibrosis on liver biopsy in paediatric subjects with nonalcoholic fatty liver disease
CLINICAL OBESITY, Vol.11(5), e12472
10/2021
DOI: 10.1111/cob.12472
PMCID: PMC8928096
PMID: 34106515
Abstract
The incidence of nonalcoholic fatty liver disease (NAFLD) in children is rapidly increasing. Liver fibrosis is a poor prognostic feature that independently predicts cirrhosis. The time that intercedes the first medical encounter and biopsy is rate-limiting to multi-modal treatment. This study aimed to identify non-invasive parameters to predict advanced NAFLD and fibrosis. We conducted a single-center, retrospective 10-year analysis of 640 paediatric patients who underwent liver biopsy. 55 patients, age 3-21 years, had biopsy-confirmed NAFLD. We assessed primary outcomes, NAFLD activity score (NAS) and fibrosis scores, against non-invasive parameters by linear regression, by using binary cutoff values, and by a multivariate logistic regression fibrosis prediction model. NAS correlated with platelets and female sex. Fibrosis scores correlated with platelet counts, gamma glutamyl transferase (GGT), and ultrasound shear wave velocity. 25-hydroxy-vitamin D and GGT differentiated mild versus moderate-to-advanced fibrosis. Our multivariate logistical regression model-based scoring system predicted F2 or higher (parameters: BMI%, vitamin D, platelets, GGT), with sensitivity and specificity of 0.83 and 0.95 (area under the ROC curve, 0.944). We identify a clinical model to identify high-risk patients for expedited biopsy. Stratifying patients to abbreviate time-to-biopsy can attenuate delays in aggressive therapy for high-risk patients.
Details
- Title: Subtitle
- A clinical model to predict fibrosis on liver biopsy in paediatric subjects with nonalcoholic fatty liver disease
- Creators
- Sakil Kulkarni - Washington University in St. LouisNadia Naz - Washington University in St. LouisHongjie Gu - Washington University in St. LouisJanis M. Stoll - Washington University in St. LouisMichael D. Thompson - Washington University in St. LouisBrian J. DeBosch - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- CLINICAL OBESITY, Vol.11(5), e12472
- DOI
- 10.1111/cob.12472
- PMID
- 34106515
- PMCID
- PMC8928096
- NLM abbreviation
- Clin Obes
- ISSN
- 1758-8103
- eISSN
- 1758-8111
- Publisher
- Wiley
- Number of pages
- 8
- Grant note
- NIH K08 DK 122018 01 / American Gastroenterological Foundation Doris Duke Charitable Foundation; Doris Duke Charitable Foundation (DDCF)
- Language
- English
- Date published
- 10/2021
- Academic Unit
- Stead Family Department of Pediatrics; Gastroenterology, Hepatology, Pancreatology, and Nutrition
- Record Identifier
- 9984701556902771
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