Logo image
Back
Non-Invasive Approaches to Estimate Liver Steatosis and Stiffness in Children With Non-Alcoholic Fatty Liver Disease
Journal article   Peer reviewed

Non-Invasive Approaches to Estimate Liver Steatosis and Stiffness in Children With Non-Alcoholic Fatty Liver Disease

Toshifumi Yodoshi, Sarah Orkin, Andrew T Trout, Ana Catalina Arce-Clachar, Kristin Bramlage, Chunyan Liu, Lin Fei, Jonathan R Dillman, Stavra A Xanthakos and Marialena Mouzaki
Journal of pediatric gastroenterology and nutrition, Vol.74(4), pp.495-502
04/01/2022
DOI: 10.1097/MPG.0000000000003371
PMID: 34908012

View Online

Abstract

To develop pediatric-specific models that predict liver stiffness and hepatic steatosis in non-alcoholic fatty liver disease (NAFLD), based on clinical and laboratory data. Children with NAFLD, who had undergone magnetic resonance imaging with proton density fat fraction (MRI-PDFF) for steatosis quantification and/or magnetic resonance elastography (MRE) for liver stiffness assessment were included. We used data from patients imaged between April 2009 to July 2018 to develop a predictive model for fat fraction and stiffness. We validated the performance of the models using data from a second cohort, imaged between 2018 and 2019. The first cohort (n = 344) consisted of predominantly non-Hispanic (80%), male (67%) adolescents. MRE data were available for 343 children, while PDFF data were available for 130. In multivariable regression, ethnicity, insulin levels, platelet count, and aspartate aminotransferase independently predicted liver stiffness and these variables were used to develop the predictive model. Similarly, sex, ethnicity, alanine aminotransferase, and triglycerides levels independently predicted liver PDFF and were used in the PDFF model. The AUC of the optimal cutoff for the model that predicted a stiffness of >2.71 kPa was 0.70 and for the model that predicted PDFF >5% was 0.78. The validation group (n = 110) had similar characteristics. The correlation coefficient of the model with the measured liver stiffness was 0.30 and with the measured liver PDFF was 0.26. Pediatric-specific models perform poorly at predicting exact liver stiffness and steatosis; however, in the absence of magnetic resonance imaging can be used to predict the presence of significant steatosis (>5%) and/or significant stiffness (>2.71). Thus, imaging remains an invaluable adjunct to laboratory investigations in determining disease severity.
 Adolescent Child Elasticity Imaging Techniques - methods Humans Liver - diagnostic imaging Liver - pathology Magnetic Resonance Imaging - methods Male Non-alcoholic Fatty Liver Disease - complications Non-alcoholic Fatty Liver Disease - diagnostic imaging Non-alcoholic Fatty Liver Disease - pathology Severity of Illness Index

Details

Metrics

1 Record Views
7 Times Cited - Web of Science
Logo image