Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 7, 2012; 18(13): 1525-1530
Published online Apr 7, 2012. doi: 10.3748/wjg.v18.i13.1525
Noninvasive Parameters and hepatic fibrosis scores in children with nonalcoholic fatty liver disease
Hye Ran Yang, Hae Ryoung Kim, Myung Jin Kim, Jae Sung Ko, Jeong Kee Seo
Hye Ran Yang, Myung Jin Kim, Jae Sung Ko, Jeong Kee Seo, Department of Pediatrics, Seoul National University College of Medicine, Seoul 110-744, South Korea
Hye Ran Yang, Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam-si, Gyonggi-do 463-707, South Korea
Hae Ryoung Kim, Department of Pathology, Seoul National University Bundang Hospital, Seongnam-si, Gyonggi-do 464-894, South Korea
Author contributions: Yang HR, Ko JS and Seo JK made substantial contributions to conception and design, drafting the article revising it critically for important intellectual content; Yang HR designed the research and wrote the paper; Yang HR and Kim MJ contributed to collect patients, the acquisition of data and analysis and interpretation; Kim HR performed the histopathological analysis; all authors approved the version to be published.
Correspondence to: Jeong Kee Seo, MD, PhD, Professor, Department of Pediatrics, Seoul National University College of Medicine, Seoul 110-744, South Korea. jkseo@snu.ac.kr
Telephone: +82-2-20723627 Fax: +82-2-20723455
Received: August 26, 2011
Revised: January 16, 2012
Accepted: February 8, 2012
Published online: April 7, 2012
Abstract

AIM: To evaluate the noninvasive parameters and hepatic fibrosis scores in obese children with nonalcoholic fatty liver disease (NAFLD).

METHODS: A total of 77 children diagnosed with NAFLD via liver biopsy were included and divided into 2 subgroups according to the histopathologic staging of hepatic fibrosis: mild (stage 0-1) vs significant fibrosis (stage 2-4). Clinical and laboratory parameters were evaluated in each patient. The aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, AST/platelet ratio index (APRI), PGA index, Forns index, FIB-4, NAFLD fibrosis score, and pediatric NAFLD fibrosis index (PNFI) were calculated.

RESULTS: No clinical or biochemical parameter exhibited a significant difference between patients with mild and significant fibrosis. Among noninvasive hepatic fibrosis scores, only APRI and FIB4 revealed a significant difference between patients with mild and significant fibrosis (APRI: 0.67 ± 0.54 vs 0.78 ± 0.38, P = 0.032 and FIB4: 0.24 ± 0.12 vs 0.31 ± 0.21, P = 0.010). The area under the receiving operating characteristic curve of FIB4 was 0.81, followed by Forns index (0.73), APRI (0.70), NAFLD fibrosis score (0.58), AST/ALT ratio (0.53), PGA score (0.45), and PNFI (0.41).

CONCLUSION: APRI and FIB4 might be useful noninvasive hepatic fibrosis scores for predicting hepatic fibrosis in children with NAFLD.

Keywords: Fatty liver, Hepatic fibrosis, Noninvasive, Obesity, Child