The assessment of liver fibrosis in children with obesity on two methods: transient and two dimensional shear wave
Cristina Oana Mărginean1, Lorena Elena Meliţ2, Dana Valentina Ghiga3
1Department of Pediatrics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Gheorghe Marinescu street no 38, Targu Mures, 540136, Romania.
Insights
Children with obesity show higher liver stiffness and abnormal lab values, indicating potential liver issues. Non-invasive methods like 2D-SWE and TE can help detect this liver impairment in pediatric obesity.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Medical Imaging
Background:
- Pediatric obesity is a growing health concern with potential liver complications.
- Non-invasive methods for assessing liver health in children are crucial.
Purpose of the Study:
- To compare liver stiffness values using 2D-Shear Wave Elastography (2D-SWE) and Transient Elastography (TE) in obese versus healthy children.
- To evaluate associated laboratory parameters in pediatric obesity and their correlation with liver stiffness.
Main Methods:
- A case-control study involving 287 children (3-18 years) divided into obese (n=77) and normal weight (n=210) groups.
- Assessment included medical history, physical examination, laboratory tests, ultrasound, and elastography (2D-SWE and TE).
Main Results:
- Obese children exhibited significantly higher platelets, AST, ALT, and AST/ALT ratio (AAR) compared to controls.
- Liver stiffness was significantly elevated in obese children using both 2D-SWE and TE.
- Velocity values measured by 2D-SWE were also significantly higher in the obese group.
Conclusions:
- Children with obesity demonstrate increased liver stiffness and abnormal liver function markers.
- 2D-SWE and TE are valuable non-invasive tools for predicting liver impairment in pediatric obesity.
Abstract:
The aim of this study was to assess the liver stiffness values in children with obesity versus healthy children on 2D-SWE and TE taking into account different laboratory parameters. We performed a case-control study on 287 children aged between 3 to 18 years, admitted in a Romanian Pediatric Tertiary Hospital, which we divided according to the body mass index (BMI) into two groups: the study group-77 children with obesity, and control group-210 children with normal weight. All children underwent anamnesis, clinical exam, laboratory parameters, ultrasound exam, and elastography. Children with obesity presented higher values of platelets, AST, ALT, and AAR as compared to control group (p = 0.0005/p = 0.0065/p < 0.0001/p < 0.0001). We found no significant differences for APRI between the two groups (p = 0.9827), although the values were higher in children with obesity. Significantly higher values of liver stiffness in children with obesity on both 2D-SWE and TE (p = 0.0314/p < 0.0001) were obtained. Similarly, the velocity values measured by 2D-SWE were also significantly higher in the study group (p < 0.0001). Our findings revealed significantly higher levels of platelets, transaminases, AAR, and liver stiffness values on both TE and 2D-SWE in children with obesity. 2D-SWE and TE might represent useful non-invasive methods for predicting liver impairment associated to pediatric obesity.
