Longitudinal changes in vibration-controlled transient elastography in pediatric fatty liver disease

Area of Science:

• Pediatric Hepatology
• Non-invasive Liver Assessment
• Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Background:

• Limited data exists on longitudinal changes in vibration-controlled transient elastography (VCTE) parameters for pediatric metabolic dysfunction-associated steatotic liver disease (MASLD).
• VCTE assesses liver stiffness and fat content, crucial for monitoring liver conditions in children.

Purpose of the Study:

• To investigate the association between changes in VCTE parameters (liver stiffness measurement [LSM] and controlled attenuation parameter [CAP]) and anthropometric/biochemical factors in pediatric MASLD.
• To establish VCTE as a monitoring tool for disease progression in pediatric MASLD.

Main Methods:

• Retrospective chart review of pediatric patients (<18 years) diagnosed with MASLD between 2015-2023.
• Collection of demographic, anthropometric (including BMI z-score), and biochemical data.
• Application of linear mixed-effects models to analyze longitudinal VCTE data (LSM and CAP) in relation to clinical parameters.

Main Results:

• A unit increase in BMI z-score was associated with a 1.02 kPa increase in LSM (p=0.012) and an 88.22 dB/m increase in CAP (p<0.001).
• Follow-up time was significantly associated with increasing liver stiffness (p=0.015), independent of baseline age and BMI z-score.
• The study included 192 pediatric patients with at least two VCTE exams, with a mean follow-up of 16.8 months.

Conclusions:

• This study is the first to describe longitudinal VCTE parameter changes in pediatric MASLD.
• Changes in BMI are positively correlated with changes in LSM and CAP in pediatric MASLD.
• VCTE demonstrates potential as an effective tool for monitoring disease status over time in children with MASLD.