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© 2022. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Vibration controlled transient elastography (FibroScan) is used to predict the severity of liver fibrosis and steatosis. In pediatrics, few studies have been performed directly comparing liver histologic features with FibroScan liver stiffness measurements (LSMs) and controlled attenuation parameters (CAPs). The FibroScan–aspartate aminotransferase (FAST) score, which predicts liver disease severity in adult nonalcoholic fatty liver disease (NAFLD), has not been analyzed in children. The aims of this study were to determine if LSM and CAP correlated with liver histologic fibrosis stage and steatosis grade, respectively, and to determine the predictive capacity of FAST in pediatric NAFLD. Research participants (n = 216) included those with FibroScan within 90 days of a liver biopsy. The ability of LSM, CAP, and FAST to predict severity of liver disease was analyzed by Spearman correlation, linear regression, and receiver operating characteristic and C statistic. Significant correlations were identified between LSM and Ishak fibrosis stages, with the strongest correlation occurring in the non‐NAFLD group (Spearman r = 0.47, p < 0.0001). LSM adequately predicted Ishak stages F0–2 versus F3–F6 (area under the receiver operating characteristic curve [AUROC], 0.73 for all; 0.77 for non‐NAFLD). CAP strongly predicted histologic steatosis grade (r = 0.84; p < 0.0001; AUROC, 0.98). FAST had acceptable discriminatory ability for significant liver disease (AUROC, 0.75). A FAST cutoff ≥0.67 had a sensitivity of 89% but a specificity of only 62% at determining significant liver disease. This study encompasses one of the largest pediatric cohorts describing the accuracy of FibroScan LSM and CAP to predict liver histologic fibrosis stage and steatosis grade, respectively. In order to determine specific LSM, CAP, and FAST cut‐off values for fibrosis stages, steatosis grades, and significant liver disease, respectively, a much larger cohort is necessary and will likely entail the need for multicentered studies.

Details

Title
The discriminatory ability of FibroScan liver stiffness measurement, controlled attenuation parameter, and FibroScan–aspartate aminotransferase to predict severity of liver disease in children
Author
Chaidez, Alexander 1 ; Pan, Zhaoxing 2 ; Sundaram, Shikha S 1 ; Boster, Julia 1 ; Lovell, Mark 3 ; Sokol, Ronald J 1 ; Mack, Cara L 4 

 Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Pediatric Liver Center, Children's Hospital Colorado, University of Colorado School of Medicine and Anschutz Medical Campus, Aurora, Colorado, USA 
 Clinical and Translational Science Institute, University of Colorado School of Medicine and Anschutz Medical Campus, Aurora, Colorado, USA 
 Department of Pathology, University of Colorado School of Medicine and Anschutz Medical Campus, Aurora, Colorado, USA 
 Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Pediatric Liver Center, Children's Hospital Colorado, University of Colorado School of Medicine and Anschutz Medical Campus, Aurora, Colorado, USA; Department of Pediatrics, Medical College of Wisconsin, Children's Hospital Wisconsin, Milwaukee, Wisconsin, USA 
Pages
3015-3023
Section
ORIGINAL ARTICLES
Publication year
2022
Publication date
Nov 2022
Publisher
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
e-ISSN
2471254X
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2727881253
Copyright
© 2022. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.