Department of Pediatrics, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
J Korean Med Sci. 2019 Jun 17;34(23):e165. doi: 10.3346/jkms.2019.34.e165.
Transient elastography (FibroScan®) is a non-invasive and rapid method for assessing liver fibrosis. While the feasibility and usefulness of FibroScan® have been proven in adults, few studies have focused on pediatric populations. We aimed to determine the feasibility and usefulness of FibroScan® in Korean children.
FibroScan® examinations were performed in 106 children (age, 5-15 years) who visited the Konyang University Hospital between June and September 2018. Liver steatosis was measured in terms of the controlled attenuation parameter (CAP), while hepatic fibrosis was evaluated in terms of the liver stiffness measurement (LSM). Children were stratified into obese and non-obese controls, according to body mass index (≥ or < 95th percentile, respectively).
The obese group was characterized by significantly higher levels of aspartate aminotransferase (AST, 57.00 ± 48.47 vs. 26.40 ± 11.80 IU/L; < 0.001) and alanine aminotransferase (ALT, 91.27 ± 97.67 vs. 16.28 ± 9.78 IU/L; < 0.001), frequency of hypertension and abdominal obesity (abdominal circumference > 95% percentile) ( < 0.001), CAP (244.4-340.98 dB/m), and LSM (3.85-7.77 kPa) ( < 0.001). On FibroScan®, 30 of 59 obese children had fibrosis (LSM > 5.5 kPa), whereas the remaining 29 did not (LSM < 5.5 kPa). Obese children with fibrosis had higher levels of AST (73.57 ± 56.00 vs. 39.86 ± 31.93 IU/L; = 0.009), ALT (132.47 ± 113.88 vs. 48.66 ± 51.29 IU/L; = 0.001), and gamma-glutamyl transferase (106.67 ± 69.31 vs. 28.80 ± 24.26 IU/L; = 0.042) compared to obese children without fibrosis. LSM had high and significant correlation ( < 0.05) with AST, ALT, homeostasis model assessment for insulin resistance, and AST-to-platelet ratio index.
FibroScan® is clinically feasible and facilitates non-invasive, rapid, reproducible, and reliable detection of hepatic steatosis and liver fibrosis in the Korean pediatric population.
瞬时弹性成像（FibroScan®）是一种用于评估肝纤维化的非侵入性和快速方法。虽然 FibroScan®在成人中的可行性和有用性已得到证实，但很少有研究关注儿科人群。我们旨在确定 FibroScan®在韩国儿童中的可行性和有用性。
2018 年 6 月至 9 月期间，在韩国康阳大学医院就诊的 106 名 5-15 岁儿童接受了 FibroScan®检查。肝脂肪变性以受控衰减参数（CAP）来衡量，肝纤维化则以肝硬度测量值（LSM）来评估。根据体重指数（≥或<95 百分位）将儿童分为肥胖和非肥胖对照组。
肥胖组的天门冬氨酸转氨酶（AST，57.00±48.47 与 26.40±11.80 IU/L；<0.001）和丙氨酸转氨酶（ALT，91.27±97.67 与 16.28±9.78 IU/L；<0.001）水平显著更高，高血压和腹型肥胖（腹部周长>95 百分位）的发生率更高（<0.001），CAP（244.4-340.98 dB/m）和 LSM（3.85-7.77 kPa）更高（<0.001）。在 FibroScan®上，59 名肥胖儿童中有 30 名患有纤维化（LSM>5.5 kPa），其余 29 名则没有（LSM<5.5 kPa）。患有纤维化的肥胖儿童的 AST（73.57±56.00 与 39.86±31.93 IU/L；=0.009）、ALT（132.47±113.88 与 48.66±51.29 IU/L；=0.001）和γ-谷氨酰转移酶（106.67±69.31 与 28.80±24.26 IU/L；=0.042）水平均显著高于无纤维化的肥胖儿童。LSM 与 AST、ALT、稳态模型评估胰岛素抵抗和 AST 血小板比值指数呈高度显著相关（<0.05）。
FibroScan®在韩国儿科人群中具有临床可行性，可用于快速、可靠地检测肝脂肪变性和肝纤维化。
