Jasmine A Jackson1, Juna V Konomi2, Michael V Mendoza2, Alyssa Krasinskas3, Ran Jin2, Shelley Caltharp3, Marialena Mouzaki4, Miriam B Vos2. 1. Emory University School of Medicine, Atlanta, Georgia, United States. 2. Department of Paediatric Gastroenterology, Hepatology and Nutrition, Emory University School of Medicine, Emory University, Atlanta, Georgia, United States. 3. Department of Pathology, Emory University, Atlanta, Georgia, United States. 4. Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Abstract
AIM: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in children. The phenotype of NAFLD varies widely, and non-invasive predictors of disease severity are scarce and are needed to tailor clinical management. METHODS: We compared liver fibrosis by histology with proposed non-invasive predictors of fibrosis, including alanine transaminase (ALT), aspartate transaminase (AST), AST/ALT ratio, AST to platelet ratio index, fibrosis-4, paediatric NAFLD fibrosis index and paediatric NAFLD fibrosis score. RESULTS: The area under the curve of scores obtained while predicting fibrosis in children with NAFLD ranged from 0.51 to 0.67. CONCLUSION: The tested non-invasive fibrosis scoring systems, some of which were originally designed for adult populations, did not adequately predict fibrosis in a paediatric cohort. Further development of risk prediction scores in children are needed for the management of paediatric patients and will likely need to be developed within a large paediatric data set in order to improve specificity and sensitivity.
AIM: Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease in children. The phenotype of NAFLD varies widely, and non-invasive predictors of disease severity are scarce and are needed to tailor clinical management. METHODS: We compared liver fibrosis by histology with proposed non-invasive predictors of fibrosis, including alanine transaminase (ALT), aspartate transaminase (AST), AST/ALT ratio, AST to platelet ratio index, fibrosis-4, paediatric NAFLD fibrosis index and paediatric NAFLD fibrosis score. RESULTS: The area under the curve of scores obtained while predicting fibrosis in children with NAFLD ranged from 0.51 to 0.67. CONCLUSION: The tested non-invasive fibrosis scoring systems, some of which were originally designed for adult populations, did not adequately predict fibrosis in a paediatric cohort. Further development of risk prediction scores in children are needed for the management of paediatric patients and will likely need to be developed within a large paediatric data set in order to improve specificity and sensitivity.
Authors: Catherine C Cohen; Eduardo Castillo-Leon; Alton B Farris; Shelley A Caltharp; Rebecca L Cleeton; Elizabeth M Sinclair; Diane E Shevell; Morten A Karsdal; Mette Juul Fisker Nielsen; Diana J Leeming; Miriam B Vos Journal: Hepatol Commun Date: 2021-07-08
Authors: Miriam B Vos; Mark L Van Natta; Niviann M Blondet; Srinivasan Dasarathy; Mark Fishbein; Paula Hertel; Ajay K Jain; Saul J Karpen; Joel E Lavine; Saeed Mohammad; Laura A Miriel; Jean P Molleston; Marialena Mouzaki; Arun Sanyal; Emily P Sharkey; Jeffrey B Schwimmer; James Tonascia; Laura A Wilson; Stavra A Xanthakos Journal: Hepatology Date: 2022-02-28 Impact factor: 17.298
Authors: Anna Di Sessa; Grazia Cirillo; Stefano Guarino; Pierluigi Marzuillo; Emanuele Miraglia Del Giudice Journal: Pediatric Health Med Ther Date: 2019-08-23
Authors: Voytek Slowik; Heather Wasserkrug; Ryan T Fischer; Mark Connelly; Amanda D Deacy; Sarah Hampl; James F Daniel Journal: Clin Transl Sci Date: 2020-11-22 Impact factor: 4.689