Performance of fibrosis prediction scores in paediatric non‐alcoholic fatty liver disease

Jackson, Jasmine A; Konomi, Juna V.; Mendoza, Michael; Krasinskas, Alyssa M.; Jin, Ran; Caltharp, Shelley A.; Mouzaki, Marialena; Vos, Miriam B.

doi:10.1111/jpc.13689

Cited by 33 publications

(39 citation statements)

References 19 publications

(60 reference statements)

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“…Fibrosis scores that use readily available clinical variables and serologic markers to predict the presence or severity of fibrosis have performed poorly in children. [126][127][128][129][130] Although use is limited by cost and availability, the Enhanced Liver Fibrosis test, hyaluronic acid, and cytokeratin-18 (CK-18) have shown promise, but require further validation. CK-18 also shows a significant association with the incidence and severity of NASH.…”

Section: Surrogate Biomarkers and Scores For Fibrosis And Nonalcoholimentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease in Children: Unique Considerations and Challenges

Goldner

Lavine

2020

Gastroenterology

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Section: Surrogate Biomarkers and Scores For Fibrosis And Nonalcoholimentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease in Children: Unique Considerations and Challenges

Goldner

Lavine

2020

Gastroenterology

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“…20 Jackson et al has also found APRI to be a modest performer in differentiating mild and significant fibrosis with an ROC of 0.67 in paediatric NAFLD cases. 21 FIB-4 index is found to be useful in diagnosis of advanced fibrosis and cirrhosis in HIV/HCV co infected patients, HBV and HCV patients. 22 Karic et al has found that FIB-4 has a greater AUC than APRI (0.875 vs 0.861) and is superior to APRI in identifying severe fibrosis in chronic hepatitis C infection.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Non-Invasive Fibrosis Scores Between Alcoholic Liver Disease Patients and Healthy Non-Alcoholics in South Indian Population

Arulvijayavani¹,

Anithasri²,

Harini³

2019

jebmh

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BACKGROUND Alcoholic Liver Disease (ALD) is a spectrum of disorders ranging from simple steatosis to steatohepatitis and cirrhosis. Various non-invasive markers have been validated as reliable prognostic markers of fibrosis in Chronic Viral Hepatitis and Non-Alcoholic Fatty Liver Disease but their utility in ALD is least evaluated. This study aims to compare the fibrosis scores in ALD patients with non-alcoholic healthy controls. METHODS The non-invasive scores of fibrosis namely AST/ALT ratio, BARD score, APRI and FIB-4 were calculated in 30 ALD cases and 30 age matched controls. Alcohol drinking pattern was evaluated using the AUDIT questionnaire. The difference in the fibrosis scores between cases and controls were calculated using independent student's t test. All statistical analysis were done using SPSS software v 20.0 and p value <0.05 was considered statistically significant. RESULTS All the non-invasive scores of fibrosis viz. AST/ALT ratio, BARD score, APRI and FIB-4 were significantly high in ALD cases compared to controls. All the cases had AST/ALT ratio more than >1, 76% of them had BARD score >2, 97% had APRI score >1 and 73% had FIB-4 score >3.25 denoting the presence of significant fibrosis in ALD patients. AUDIT score correlates with all the non-invasive fibrosis scores except AST/ALT ratio. There is significant correlation between FIB-4 score and APRI score (r= 0.962, p=<0.001) and between FIB-4 score and AST/ALT ratio (r= 0.500 p= 0.005). CONCLUSIONS The non-invasive fibrosis markers are significantly high in ALD cases. APRI, FIB4 and BARD score positively correlate with alcohol drinking pattern. Hence these scores derived from routine lab investigations could be used as cost effective tools to assess the severity of fibrosis in ALD patients.

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“…In addition, no reliable clinical guidelines concerning when to perform liver biopsy in children with NAFLD currently exist. A recent retrospective chart review study examined the efficacy of non-invasive hepatic fibrosis predictors, including the AST:ALT ratio, APRI levels, FIB-4 levels, the pediatric NAFLD fibrosis index, and the pediatric NAFLD fibrosis score [36]. They found that these noninvasive fibrosis markers did not adequately predict fibrosis.…”

Section: Nomogram Predicting Nafld In Obese Childrenmentioning

confidence: 99%

A Nomogram for Predicting Non-Alcoholic Fatty Liver Disease in Obese Children

Kim

Yang

Cho

et al. 2020

Pediatr Gastroenterol Hepatol Nutr

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Purpose: Non-alcoholic fatty liver disease (NAFLD) ranges in severity from simple steatosis to steatohepatitis. Early detection of NAFLD is important for preventing the disease from progressing to become an irreversible end-stage liver disease. We developed a nomogram that allows for non-invasive screening for NAFLD in obese children. Methods: Anthropometric and laboratory data of 180 patients from our pediatric obesity clinic were collected. Diagnoses of NAFLD were based on abdominal ultrasonographic findings. The nomogram was constructed using predictors from a multivariate analysis of NAFLD risk factors. Results: The subjects were divided into non-NAFLD (n=67) and NAFLD groups (n=113). Factors, including sex, body mass index, abdominal circumference, blood pressure, insulin resistance, and levels of aspartate aminotransferase, alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γGT), uric acid, triglycerides, and insulin, were significantly different between the two groups (all p<0.05) as determined using homeostatis model assessment of insulin resistance (HOMA-IR). In our multivariate logistic regression analysis, elevated serum ALT, γGT, and triglyceride levels were significantly related to NAFLD development. The nomogram was established using γGT, uric acid, triglycerides, HOMA-IR, and ALT as predictors of NAFLD probability. Conclusion: The newly developed nomogram may help predict NAFLD risk in obese children. The nomogram may also allow for early NAFLD diagnosis without the need for invasive liver biopsy or expensive liver imaging, and may also allow clinicians to intervene early to prevent the progression of NAFLD to become a more advanced liver disease.

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Performance of fibrosis prediction scores in paediatric non‐alcoholic fatty liver disease

Cited by 33 publications

References 19 publications

Nonalcoholic Fatty Liver Disease in Children: Unique Considerations and Challenges

Nonalcoholic Fatty Liver Disease in Children: Unique Considerations and Challenges

Comparison of Non-Invasive Fibrosis Scores Between Alcoholic Liver Disease Patients and Healthy Non-Alcoholics in South Indian Population

A Nomogram for Predicting Non-Alcoholic Fatty Liver Disease in Obese Children

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