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Updated: Oct 11, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Costs of two-step MASLD screening using ALT and elastography in children with overweight and obesity
Anne-Sophie R Stroes1, Eva Muntjewerff2, Laura Draijer2
1Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands.
Objectives:
Metabolic dysfunction-associated steatotic liver disease (MASLD) is prevalent among children with obesity. Although screening is widely performed in pediatric obesity-related comorbidity assessment, evidence on effectiveness and costs is lacking. This study quantifies costs of MASLD screening using ALT and vibration-controlled transient elastography (VCTE) in children with overweight and obesity.
Methods:
We prospectively analyzed costs of a two-step MASLD screening strategy in obesity clinics in the Amsterdam region. Children with overweight and obesity underwent ALT testing; those with elevated ALT were referred for further assessment according to MASLD guidelines. Healthcare and societal costs were calculated per child screened and per advanced MASLD case detected (VCTE ≥7.4 kPa). Scenario 1 included limited additional testing for other liver disorders and scenario 2 more elaborate testing.
Results:
In a screened population of 2376 children, healthcare costs were €144 per child screened and €5608 per advanced MASLD case detected; healthcare and societal costs combined were €201 per child screened and €7822 per case detected. Scenario 2 increased healthcare costs by 15%.
Conclusions:
This study provides novel cost data on pediatric MASLD screening, which may inform policy and implementation strategies for children with overweight and obesity.
