Abhinav Anand1, Manisha Jana2, Devasenathipathy Kandasamy2, Brijesh Kumar3, Gajendra Singh3, Vandana Jain4. 1. Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India. 2. Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India. 3. Division of Pediatric Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India. 4. Division of Pediatric Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India. drvandanajain@aiims.edu.
Abstract
OBJECTIVE: To identify controlled attenuation parameter (CAP) based cutoffs for diagnosing and grading hepatic steatosis in adolescents with overweight/obesity, using magnetic resonance imaging-proton density fat fraction (MRI-PDFF) as the reference method. METHODS: Adolescents with overweight/obesity were included. Fasting glucose, insulin, aspartate aminotransferase, and alanine aminotransferase were estimated. Hepatic steatosis (S) was assessed by MRI-PDFF, and graded as S0, S1, S2, and S3 with fat fraction cutoffs of < 6.0%, ≥ 6.0% to < 17.5%, ≥ 17.5% to < 23.3%, and ≥ 23.3%, respectively. CAP and liver stiffness measure (LSM) were assessed using FibroScan. Receiver operating characteristic (ROC) curves were used to estimate the CAP scores predicting various grades of hepatic steatosis. RESULTS: A total of 108 adolescents aged 12.4 ± 1.9 y, with mean BMI of 26.7 ± 4.9 kg/m2 were included. S0, S1, S2, and S3 steatosis by MRI-PDFF was identified in 15, 70, 13, and 10 adolescents, respectively. A moderate positive correlation was observed between CAP score and MRI-estimated hepatic fat (r = 0.528, p < 0.001). The optimal CAP cutoffs for identifying ≥ S1, ≥ S2, and S3 steatosis were 271 [area under ROC (AUROC) 0.745 (0.630-0.859)], 296 [AUROC 0.820 (0.728-0.911)], and 309 dB/m [AUROC 0.836 (0.729-0.944)], respectively. CONCLUSION: CAP score had a good discriminative ability to diagnose fatty liver in adolescents with overweight or obesity.
OBJECTIVE: To identify controlled attenuation parameter (CAP) based cutoffs for diagnosing and grading hepatic steatosis in adolescents with overweight/obesity, using magnetic resonance imaging-proton density fat fraction (MRI-PDFF) as the reference method. METHODS: Adolescents with overweight/obesity were included. Fasting glucose, insulin, aspartate aminotransferase, and alanine aminotransferase were estimated. Hepatic steatosis (S) was assessed by MRI-PDFF, and graded as S0, S1, S2, and S3 with fat fraction cutoffs of < 6.0%, ≥ 6.0% to < 17.5%, ≥ 17.5% to < 23.3%, and ≥ 23.3%, respectively. CAP and liver stiffness measure (LSM) were assessed using FibroScan. Receiver operating characteristic (ROC) curves were used to estimate the CAP scores predicting various grades of hepatic steatosis. RESULTS: A total of 108 adolescents aged 12.4 ± 1.9 y, with mean BMI of 26.7 ± 4.9 kg/m2 were included. S0, S1, S2, and S3 steatosis by MRI-PDFF was identified in 15, 70, 13, and 10 adolescents, respectively. A moderate positive correlation was observed between CAP score and MRI-estimated hepatic fat (r = 0.528, p < 0.001). The optimal CAP cutoffs for identifying ≥ S1, ≥ S2, and S3 steatosis were 271 [area under ROC (AUROC) 0.745 (0.630-0.859)], 296 [AUROC 0.820 (0.728-0.911)], and 309 dB/m [AUROC 0.836 (0.729-0.944)], respectively. CONCLUSION: CAP score had a good discriminative ability to diagnose fatty liver in adolescents with overweight or obesity.