Transient Elastography-Based Liver Profiles in a Hospital-Based Pediatric Population in Japan
Yuki Cho1, Daisuke Tokuhara1, Hiroyasu Morikawa2
1Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan.
Insights
Transient elastography (FibroScan) is feasible in children for assessing liver health. Childhood obesity is linked to higher risks of hepatic steatosis and liver stiffness, making FibroScan an effective screening tool.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Medical Imaging
Background:
- Transient elastography (FibroScan) is widely used in adults but its utility in children is less understood.
- Assessing liver health in pediatric populations, particularly concerning obesity-related liver disease, is crucial.
Purpose of the Study:
- To evaluate the feasibility of performing FibroScan in Japanese children.
- To characterize liver profiles, including steatosis and fibrosis, in obese versus non-obese children using FibroScan.
Main Methods:
- FibroScan examinations were conducted on pediatric patients aged 1-18 years.
- Controlled Attenuation Parameter (CAP) for steatosis and Liver Stiffness Measurement (LSM) for fibrosis were assessed.
- Participants were categorized into obese (BMI percentile ≥ 90%), non-obese healthy controls, and non-obese liver disease groups.
Main Results:
- FibroScans were successfully performed in 93.9% of 214 pediatric patients.
- Obese children showed significantly higher CAP values compared to control and liver disease groups.
- While obese children had higher LSM than controls, no significant difference was found between obese and liver disease groups.
Conclusions:
- Childhood obesity is associated with a high risk of hepatic steatosis and increased liver stiffness.
- FibroScan is a feasible, non-invasive, and effective screening method for hepatic steatosis and fibrosis in Japanese children, including those who are obese.
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 (ρ = 0.511) but not in the control (ρ = 0.129) or liver disease (ρ = 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.
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