Elevated Alpha-Fetoprotein Levels in Children with Metabolic Dysfunction-Associated Liver Disease

Area of Science:

• Pediatric Hepatology
• Gastroenterology
• Metabolic Disorders

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) can lead to severe liver conditions like hepatocellular carcinoma (HCC).
• Elevated alpha-fetoprotein (AFP) is a marker often associated with liver disease progression and HCC.
• The role of AFP in pediatric MASLD, particularly concerning fibrosis severity, requires further investigation.

Purpose of the Study:

• To determine the prevalence of elevated AFP in children with advanced MASLD-related fibrosis (bridging fibrosis or cirrhosis).
• To assess the association between pediatric MASLD and AFP elevation, irrespective of fibrosis stage.

Main Methods:

• Retrospective cohort study of pediatric patients (6-18 years) with MASLD between 2000-2024.
• Data collection included demographics, anthropometrics, blood work, liver biopsy results, and imaging.
• Descriptive statistics were employed to analyze the data.

Main Results:

• Out of 483 pediatric MASLD patients, 161 had liver biopsies, with 22 showing advanced fibrosis.
• No patients with advanced fibrosis exhibited elevated AFP levels.
• Nine patients in the entire MASLD cohort had elevated AFP, none with HCC or other tumors.

Conclusions:

• Advanced fibrosis in pediatric MASLD is not associated with elevated AFP levels.
• While AFP elevations can occur in pediatric MASLD, they do not appear to be linked to malignancies in this cohort.