ASSESSMENT OF THE HEPATIC AND PANCREATIC STRUCTURE WITH SHEAR WAVE ELASTOGRAPHY AND STEATOMETRY IN OBESE CHILDREN.

The transabdominal elastography method requires estimation of liver and pancreatic structure in terms of its stiffness. Whether the results in children may be affected by anthropometric data is still the question. Objective. To evaluate the influence of obesity on liver and pancreatic stiffness parameters in children according to shear wave elastography data and to determine the major factors affecting the liver and pancreatic elasticity. This case-control study included 101 patients aged 6 to 17 years with an average age of patients (11,60±2,30) years. Determination of liver (LS) and pancreatic stiffness (PS) were carried out by shear wave elastography with SONEUS P7 system (Ultrasign, Ukraine- Switherland). Steatometry with the determination of the average ultrasound attenuation coefficient (aUAC) was performed with SONEUS P7 (Ultrasign, Ukraine-Switherland). According to the presence of obesity patients were divided into 2 groups: 1 group - 59 obese children, 2 group - 42 patients without obesity. Baseline descriptive variables included age, gender, body mass index, waist circumference (WC), laboratory data (general blood count and liver/pancreas function test, high density lipoproteins level). Insulin level was assessed by ELISA with calculation of HOMA1-IR. The average values of LS in obese and nonobese children were (4,98±0,83) kPa and (4,83±1,04) kPa, respectively, (p>0,05). Pancreatic stiffness also didn't differ between groups - (3,55±0,81) kPa and (3,60±0,448) kPa in 1st and 2d groups, respectively (p>0,05). LS positively correlated with body weight, WC, HOMA1-IR, aUAC (p<0,05). Also, we determined that liver aUAC had influence on liver stiffness (r=0,25, p<0,05) as well as pancreatic aUAC had influence on pancreatic stiffness (r=0,25, p<0,05). Obesity by itself did not affect the stiffness of the liver and pancreas according to the data of shear wave elastography. Pancreatic and liver stiffness showed association with metabolic changes. Steatometry can be useful tool for differentiation of fibrosis/inflammation and steatosis and so can improve specifity of elastography.