Transient Elastography-Based Liver Profiles in a Hospital-Based Pediatric Population in Japan

Background & Aims The utility of transient elastography (FibroScan) is well studied in adults but not in children. We sought to assess the feasibility of performing FibroScans and the characteristics of FibroScan-based liver profiles in Japanese obese and non-obese children. Methods FibroScan examinations were performed in pediatric patients (age, 1-18 yr) who visited Osaka City University Hospital. Liver steatosis measured by controlled attenuation parameter (CAP), and hepatic fibrosis evaluated as the liver stiffness measurement (LSM), were compared among obese subjects (BMI percentile >= 90%), non-obese healthy controls, and non-obese patients with liver disease. Results Among 214 children examined, FibroScans were performed successfully in 201 children (93.9%; median, 11.5 yr; range, 1.3-17.6 yr; 115 male). CAP values (mean +/- SD) were higher in the obese group (n = 52, 285 +/- 60 dB/m) compared with the liver disease (n = 40, 202 +/- 62, P<0.001) and the control (n = 107, 179 +/- 41, P<0.001) group. LSM values were significantly higher in the obese group (5.5 +/- 2.3 kPa) than in the control (3.9 +/- 0.9, P<0.001), but there were no significant differences in LSM between the liver disease group (5.4 +/- 4.2) and either the obese or control group. LSM was highly correlated with CAP in the obese group (rho = 0.511) but not in the control (rho = 0.129) or liver disease (rho = 0.170) groups. Conclusions Childhood obesity carries a high risk of hepatic steatosis associated with increased liver stiffness. FibroScan methodology provides simultaneous determination of CAP and LSM, is feasible in children of any age, and is a non-invasive and effective screening method for hepatic steatosis and liver fibrosis in Japanese obese children.