Noninvasive assessment of liver steatosis in children: the clinical value of controlled attenuation parameter

被引：70

作者：

Ferraioli, Giovanna ^{[1
]}

Calcaterra, Valeria ^{[2
]}

Lissandrin, Raffaella ^{[1
]}

Guazzotti, Marinella ^{[3
]}

Maiocchi, Laura ^{[1
]}

Tinelli, Carmine ^{[4
]}

De Silvestri, Annalisa ^{[4
]}

Regalbuto, Corrado ^{[2
]}

Pelizzo, Gloria ^{[3
]}

Larizza, Daniela ^{[2
]}

Filice, Carlo ^{[1
]}

机构：

[1] Univ Pavia, Fdn IRCCS Policlin San Matteo, Dept Infect Dis, Ultrasound Unit, Viale Camillo Golgi 19, I-27100 Pavia, Italy

[2] Univ Pavia, Fdn IRCCS Policlin San Matteo, Dept Mother & Child Hlth, Pediat Unit, Pavia, Italy

[3] Univ Pavia, Fdn IRCCS Policlin San Matteo, Dept Mother & Child Hlth, Pediat Surg Unit, Pavia, Italy

[4] Fdn IRCCS Policlin San Matteo, Clin Epidemiol & Biometr Unit, Pavia, Italy

来源：

BMC GASTROENTEROLOGY | 2017年 / 17卷

关键词：

Liver steatosis; Pediatric series; NAFLD; Obesity; Controlled attenuation parameter; Ultrasound; Transient elastography; BODY-MASS INDEX; HEPATIC STEATOSIS; DONOR LIVER; DISEASE; PREDICTOR; ACCURACY; OBESITY; BURDEN; EUROPE;

D O I：

10.1186/s12876-017-0617-6

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: To assess the clinical validity of controlled attenuation parameter (CAP) in the diagnosis of hepatic steatosis in a series of overweight or obese children by using the imperfect gold standard methodology. Methods: Consecutive children referred to our institution for auxological evaluation or obesity or minor elective surgery were prospectively enrolled. Anthropometric and biochemical parameters were recorded. Ultrasound (US) assessment of steatosis was carried out using ultrasound systems. CAP was obtained with the FibroScan 502 Touch device (Echosens, Paris, France). Pearson's or Spearman's rank correlation coefficient were used to test the association between two study variables. Optimal cutoff of CAP for detecting steatosis was 249 dB/m. The diagnostic performance of dichotomized CAP, US, body mass indexes (BMI), fatty liver index (FLI) and hepatic steatosis index (HSI) was analyzed using the imperfect gold standard methodology. Results: Three hundred five pediatric patients were enrolled. The data of both US and CAP were available for 289 children. Steatosis was detected in 50/289 (17.3%) children by US and in 77/289 (26.6%) by CAP. A moderate to good correlation was detected between CAP and BMI (r = 0.53), FLI (r = 0.55) and HSI (r = 0.56). In obese children a moderate to good correlation between CAP and insulin levels (r = 0.54) and HOMA-IR (r = 0.54) was also found. Dichotomized CAP showed a performance of 0.70 (sensitivity, 0.72 [0.64-0.79]; specificity, 0.98 [0.97-0.98], which was better than that of US (performance, 0.37; sensitivity, 0.46 [0.42-0.50]; specificity, 0.91 [0.89-0.92]), BMI (performance, 0.22; sensitivity, 0.75 [0.73-0.77]; specificity, 0.57 [0.55-0.60]) and FLI or HSI. Conclusions: For the evaluation of liver steatosis in children CAP performs better than US, which is the most widely used imaging technique for screening patients with a suspicion of liver steatosis. A cutoff value of CAP of 249 dB/m rules in liver steatosis with a very high specificity.

引用

页数：9

共 21 条

[1] The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population [J].